加盟合作申请意向表

1、2.PAPA JOHN S INTERNATIONAL, INC.2002 PAPA JOHNS BLVD., LOUISVILLE, KY 40299PHONE 502.261.7272 FAX 502.261.4140Better Ingredients.Better Pizza.GLOBALBUSINESSDEVELOPMENT全球商业发展REQUEST FOR CONSIDERATION FORM加盟合作申请意向表The information requested in this form is used to evaluate your qualifications to be aw

2、arded a Papa John(Please print or type your resp on ses.)该表所要求填写的信息用以评估是否具备加盟棒！约翰的资格。(请打印表格内容)PERSONAL DATA个人信息Name:Date of Birth:姓名：出生日期：Social Security, Passport or Country ID Number:_社保号、护照号或身份证号：Address:_地址：State, Coun try, Zip Code:国家省份邮编：Citize nship:-国籍：Email Address:_电子邮件地址：Home Telephone:家庭

3、电话：Busi ness Telephone_单位电话：Mobile Teleph one:手机：Facsimile:传真：Marital Status:婚姻状况：Spouse s Name配偶姓名：What specifically drove you to con tact Papa Joh ns at this time? (Please be specific as to the exact n ewspaper,magaz ine, etc.)这一次是什么促Area(s) of In terest:有意向的区域：1._Number of Un its You Wish to Deve

4、lop:希望开设店铺数量：2.PAPA JOHN S INTERNATIONAL, INC.2002 PAPA JOHNS BLVD., LOUISVILLE, KY 40299PHONE 502.261.7272 FAX 502.261.4140PAPA JOHN S INTERNATIONAL, INC.2002 PAPA JOHNS BLVD., LOUISVILLE, KY 40299PHONE 502.261.7272 FAX 502.261.4140BUSINESS EXPERIENCE商业经验r Please list prese nt or most recent compa

5、ny in formatio n.请列举目前或最近公司信息。Compa ny Name:公司名称：Type of Busi ness:_企业类型：Address:_地址：Papa Joh n s Intern ati on al, I nc.Request for Con siderati on FormPage Two棒！约翰 国际有限公司加盟合作申请意向表 第 2 页Present / Most Recent Position: _目前/最近职位：Dates Positi on Held:_任职日期：Number of People You Directly Man age: _直接管理人

6、数：Previous Positio ns:-之前职位：Have You Ever Owned a Bus in ess?是否曾经拥有过一家企业？Yes有No无If Yes, What Type of Busin ess?如果有，是什么企业类型？Do You Pla n to Devote Full Time to This Bus in ess Ven ture?YesNo您是否计划全职经营这次商机？是否Will You Have Equity Part ners?YesNo您是否有股东合伙人？是否(If yes, please ide ntify all part ners in the

7、Bus in ess Structure sect ion of this form.)(如果是，请在本表格的商业结构栏中写明所有合伙人。)Why do you believe you can successfully operate a Papa John s franchise in you? area(s) of interest您为何认为自己能够在所意向区域成功经营棒！约翰？PAPA JOHN S INTERNATIONAL, INC.2002 PAPA JOHNS BLVD., LOUISVILLE, KY 40299PHONE 502.261.7272 FAX 502.261.41

8、40Additional information you would like to share with us in evaluating your Request for Consideration form: 愿意提供用来评估申请意向表的其他信息：Are you now, or have you in the previous ten years, bee n aNoparty to any lawsuit, arbitrati on, mediati on, ban kruptcy or other legalproceed ing?您目前或在前十年内是否参与任何诉讼、 裁决、 调解、

9、 破产或其他法律诉讼? 否If yes, please provide details:如果是，请提供纟田节:Have you ever bee n con victed of a felony?_ YesNo您是否曾犯有重罪？_是_ 否If yes, please provide details:如果是，请提供纟田节:Papa Joh n s Intern ati on al, I nc.Request for Con siderati on FormPage Three棒！约翰 国际有限公司加盟合作申请意向表 第 3 页PFRSONAL FINANCIAL STATFMENT个人财务报告P

10、ers onal Finan cial Stateme nt as of: 个人财务报告，自（日期）：Name:姓名:Address:地址:_ Yes_ 是 _PAPA JOHN S INTERNATIONAL, INC.2002 PAPA JOHNS BLVD., LOUISVILLE, KY 40299PHONE 502.261.7272 FAX 502.261.4140Social Security Number or other Country ID Number: 社会保险编号或其他国家身份证号：Assets:资产：Amount in US $:以美元计：Cash - check i

11、ng accou nts 现金一活期存款-Cash - sav ings accou nts 现金一储蓄存款Certificates of deposit 存款单Securities - stocks / bonds / mutual fun ds 有价证券一股票 / 债券 / 共同基金Notes & con tracts receivable 应收票据和契约Automobiles 汽车Vested in terest in defferred compe nsati on/profit shari ng pla ns 递延补偿/利益分配计划中的既得利益Real estate (market

12、value)房地产(市值)Other assets (specify)其他资产(请注明)Other assets (specify)其他资产(请注明)Total Assets:总资产：_Liabilities:债务：Amount in US $:以美元计:Current Debt (Credit cards, Accounts)目前债务(信用卡、账 单)Notes payable (describe below)应付票据(在下面描述)Taxes payable 应付税款Real estate mortgages (describe)房地产抵押(请描述)Other liabilities (sp

13、ecify)其他债务(请注明)Other liabilities (specify)其他债务(请注明)Total Liabilities: 总债务：_Net Worth:资产净值：_Papa Joh n s Intern ati on al, I nc.Request for Con siderati on FormPage Four棒！约翰 国际有限公司加盟合作申请意向表 第 4 页PROPOSED COMPANY STRUCTURF规划公司结构A.Proposed Own er(s):计划所有者：Name:Address:Social Security Number:Active in F

14、ran chise?姓名：地址：社会保险编号：目前是否有特许经营？1.PAPA JOHN S INTERNATIONAL, INC.2002 PAPA JOHNS BLVD., LOUISVILLE, KY 40299PHONE 502.261.7272 FAX 502.261.41402._3._B.Proposed Principal Operator:建议主要经营者：Name:Address:Social Security Number:姓名：地址：社会保险编号：C.What will be your company s organizational structure (e.g., P

15、artnership, Corporation, LLC, etc.)?_您将采取何种公司结构(如合伙公司、股份有限公司、有限责任公司等)？D.If lender financing, please name specific resources: _女E.Please attach a resume or C.V. and finan cial stateme nt for each proposed owner and your Prin cipal Operator candidate.请附上每位计划所有者和主要经营者申请人的简历和财务报表。ACKNOWLEDGEMENT确认By sig

16、ning and submitting this form to Papa Johns International, Inc., you hereby authorize Papa JohnsIntern ati on al, I nc. and or its age nt to perform backgro und checks in cludi ng obta ining your con sumer credit report froma credit report ing age ncy. Your sig nature also authorizes, without reservati on, any age ncies con tacted to furnish yourconsumer credit information and release all parties involved from any liability and responsibility for doing so. Thisauthorization and consen