Application for Consideration

Submission of the following information will be used in the preliminary determination of your eligibility for a
Baja Sol Restaurants franchise. This application is not an offer of a franchise; rather, it constitutes a request
for additional information. Please note: a separate Application for Consideration must be completed for
each person requesting information about a Baja Sol Restaurants franchise.

APPLICANT
Name (first, middle, last) :
 		Street Address :
City :

 State :
ZIP Code :

 
Social Security Number :
Driver's License No./exp :
Date of Birth :

US Citizen? (check one) :Yes No If no, explain:
 
 
Home Phone Number :

 Cell phone :
 Email Address :
 
 
SPOUSE
Name (first, middle, last):
 City :
State :
 ZIP Code :
 
Social Security Number :
 Driver's License No./exp :
Date of Birth :
 US Citizen? (check one) : Yes No If no, explain:
 
 
Home Phone Number :


 Business Phone :


Cell phone :


Email Address :
 
 
REFERRAL SOURCE
 
Magazine , Store visit, Trade Show,Internet,Other:
 
EDUCATION
 
High School :

 Address :
 Years Attended :
 Degree(s) earned :


College :
 Address :
Years Attended :
Degree(s) earned :





Graduate Work :
Address :


Years Attended :
Degree(s) earned :


EMPLOYMENT HISTORY (Please indicate if self-employed)
Position :
Company/Location :
 Type of Business :
 Gross Salary :
From :
To :
 
Position :
 Company/Location :
 Type of Business :
 Gross Salary :
From :
To :
 
FRANCHISE EXPERIENCE (if applicable)
 
Have you ever been a franchisee of another company? Yes No If yes, please list company(ies) and date(s):
 
EQUITY PARTNERS
Do you plan to have equity partners? Yes No If yes, please identify all partners below:
 
 
Name :
 Address :
Social Security # :
Phone :
 
Name :
Address :
Social Security # : Phone :
 
Name :
Address :
Social Security # :
Phone :
 
MANAGEMENT
 
Do you plan to be a full time owner operator? Yes No
 
If not, do you plan to have an operating partner? Yes No (please attach resume of individuals involved, if applicable)
 
PREFERRED AREAS
Baja Sol Restaurants Group actively seeks out locations.
Ask our office about pre-qualified sites in your preferred areas.
 
First Choice :
Second Choice :
Third Choice :
 
GENERAL INFORMATION
 
Have you been a plaintiff or a defendant in any legal action during the last ten years? YES NO
Have you, or any entity in which you owned an equity interest, filed for bankruptcy? YES NO
Have you been arrested for, or charged with, a criminal offense? YES NO
 
Name all actions describing type of action, when and where filed and disposition:
 
PERSONAL FINANCIAL INFORMATION
 
Assets
1. Cash:

2. Stocks / Mutual Funds:


3. Cash Value of Life Insurance:


4. Accounts and Loans Receivable:


5. Value of Retirement Accounts:


6. Personal Residence Value:


7. Value of Real Estate Owned:


8. Personal Property:
 
TOTAL ASSETS:
 
Liabiltities
 
1. Notes Due to Banks:

2. Notes Due to Others (credit cards, etc.):

3. Mortgage on Personal Residence:

4. Mortgage Payable on Real Estate:

5. Taxes and Assessments Payable:

6. Other Liabilities:

 
TOTAL LIABILTIES:


NET WORTH:
 
FINANCIAL AND TRADE REFERENCES
 
Name, Address, Telephone

1-

2 -

3-
 





Signature:

Date:


Baja Sol Franchising, Inc.
2922 Upper 55th St E, Inver Grove Heights, MN 55076
Main: 651-554-1111 Fax: 651-554-1112