Personal Information
Name:
Home Phone:
Address:
City:
Province:
Postal Code:
Business Phone:
Email:
Drivers License #:
Social Insurance Number:
Spouse's Name:
Number of Dependants:
Have you ever been convicted of a criminal offence?	No Yes
Have you or any company you were associated with entered receivership or bankruptcy?	No Yes
Explain:

Experience
Your Occupation: Employer: Dates:
Responsibilities:
Previous Occupation: Employer: Dates:
Responsibilities:
Previous Occupation: Employer: Dates:
Responsibilities:
Your Spouses Occupation: Employer: Dates:
Responsibilities

Education
Level of Public Education Completed:
Level of Post Secondary Education Completed:
Other Training Certificates or Courses

Self Employment Review
Will you devote yourself to the business full time?	No Yes
If no, how will the business operate successfully?
Are you considering a partner?	No Yes
Who?
What other franchise or business opportunities have you examined?	1. 2. 3.
Are you willing to relocate to open your new business?	No Yes
What geographic areas are you interested in?
First Choice:
Second Choice:
Have you ever been Self Employed? If yes, please outline business:
What is the minimum income you require during the first year of operation?	$
During the second year?	$
During the third year?	$
What skills and interests can you contribute to a Ruffin's Pet Centre franchise?
Please describe any pet related interests

Household Income
Salary	$
Spouse's Salary	$
Investment Income	$
Other Income	$
Total Annual Income	$

Assets
Value
Your Residence:			Year Purchased:		Purchase Price:	$	$
Your Vehicles:	Year:		Make:		Model:		$
	Year:		Make:		Model:		$
						Other Assets	$
						RRSP's, Bonds,	$
						Mutual Funds,	$
						Stocks, Real	$
						Estate, etc.	$
						Total Assets:	$

Where do you bank:
Address:
Type of accounts:
Chequing	$
Average Balance	$
Savings	$
Average Balance	$
Can you personally meet a minimum cash investment in the business of $ 35,000?	No Yes
If no, how will you pay for your franchise investment?

Financial Dealing:
	Purpose	Amount Owing	Monthly Payment
Mortgage 1		$	$
Mortgage 2		$	$
Loan 1		$	$
Loan 2		$	$
Credit Card		$	$
Other Debt		$	$
Totals		$	$

References:
Please provide two references, personal or business, that we may contact
Name:
Address:
Phone:
Name:
Address:
Phone:

Your application is now ready to be submitted. If you are satisified with the information you've added, please click "Submit Application" now. Otherwise you may choose "Previous Step" and make changes as you see fit.