First Name:     

Middle Name: 

Last Name: 

Date Of Birth (MM/DD/YYYY):

Are You a US Citizen: Yes No

If no, what country?

Residence Address:

City, State:  

Zip:

How Long have you lived at this address?:

Best phone number to reach you:        Home Phone:

Cell Phone:                                          Fax:

Email Address:

Education

High School: (Highest grade or degree attained)

Junior College/Tech: (Hightest grade or degree attained)

College: (Highest grade or degree attained)

General Information

Have you ever eaten at Wingers?: Yes  No

Do you have any experience in the restaurant business or any formal training?: Yes  No

What kind of experience?:

Are you looking to run the business yourself?: Yes  No

Do you have other owners/partners?: Yes  No

If yes, who are they?:

What is your timeline for getting started?:  

Why do you desire to join the Winger's team?:

What market or markets are you looking to develop a Winger's Business?:

      1st Choice:

      2nd Choice:

Are you looking for a single store development? Yes  No

Are you looking to become a Winger's multi-store developer?: Yes  No

How did you hear about Winger's?

Employment Information

Are you : Employed  Self Employed   Unemployed (please skip financial section)
Retired (please skip financial section)

Name of Company/Employer:  

Position:

Type of Business:

Name of Company/Employer:  

Position:

Type of Business:

Name of Company/Employer:  

Position:

Type of Business:

Assets

Total Liquid Assets Available: (e.g. cash, stock, bonds, mutual funds)  
($50,000 Liquid Capital Required)

Total Tangible Assets: (e.g. house, car, business, etc.)  

Total Liabilities:

If you don't meet our financial requirement we ask that you explain how you will fund your Winger's business:

($200,000 total net worth required)

Legal Information

Are you currently involved in any lawsuits? Yes  No

If yes, identify discharge date: (MM/DD/YYYY)

Have you ever filed for bankruptcy protection?: Yes  No

Are you or anyone in your immediate family a partner or owner (partial or otherwise) of a restaurant?: Yes  No

If yes, list name of business and family relationship:

Are you or anyone in your immediate family employed by a restaurant?: Yes  No

If yes, list name of employer and family relationship:

Are you or anyone in your immediate family currently under any form of non-competition agreement that limits your right to operate any business?: Yes  No

If yes, list name of employer and family relationship:

Have you ever been convicted of a felony: Yes  No

References (Please complete all three entries)

Name:

Years you have known this person:

Relation of this person to you:

Phone Number and Area Code:

Name:

Years you have known this person:

Relation of this person to you:

Phone Number and Area Code:

 Name:

Years you have known this person:

Relation of this person to you:

Phone Number and Area Code:

I understand that the granting of a franchise is at the sole discretion of the Franchisor (Winger's). I understand that the information I am receiving from Winger's, or from any Winger's associate, employee, agent, or franchise is highly confidential, has been developed with a great deal of effort and expense to Winger's, and is being made available to me because of this application, and will be held in strictest confidence.

I will not divulge or use any data, customer or employee names and addresses, techniques, methods, advertising material, forms, or other information of whatever kind received from the Franchisor without consent. I authorize the procurement of an investigative consumer report and understand that it may contain information about my background, character, general reputation, mode of living, credit worthiness and job performance. I understand that, upon written request within a reasonable period of time, I am entitled to additional information concerning the nature and scope of this investigation. I hereby release Winger's, its legal representatives, and their officers, agents, employees and servants from any liability arising from or relating to the preparation of this report or investigation relation thereto.

This authorization for release of information includes but is not limited to matters of opinion relating to my character, ability, reputation and past performance. I authorize all persons, schools, companies, corporations, financial institutions, credit agencies and bureaus, courts, and law enforcement agencies to release such information without restriction or qualification to Winger's, its representative, or any of their officers, agents, employees and servants. I voluntarily waive all recourse and release them from liability from complying with this authorization, and I hereby release Winger's, and its representatives, and their officers, agents, employees, and servants, from any liability on account of the provision of such information or the use of such information in connection with this application. This authorization/release shall apply to his as well as any future request for an investigative consumer report by Winger's. I authorize that a photocopy or facsimile of this release be considered as valid as the original.

I have read this application and everything I have stated in it is true. Additionally, I understand the filing of this application does no obligate me the applicant to purchase or the franchisor to sell a franchise. I understand that the information provided by me will be relied upon by the Franchisor. I certify that the statements in this application are complete, and I have no withheld information affecting my reputation or credit standing.

I accept the above terms:

Yes  No