Geowash Franchisee Application Form

PERSONAL DETAILS

First Name(s)*
Last Name*
Phone
Postal Address
State
Email Address*
Fax Number
Mobile*
Web Page

PARTNER'S DETAILS

Full Name
No. of Dependants
Ages

OTHER DETAILS

Country of Birth
Are you a naturalised citizen ?*
YesNo
Are you a fluent English Speaker ?
YesNo
Languages spoken (other than English)

BUSINESS REFERENCES (If Appropriate)

Company 1
Phone
Name & Position
Company 2
Phone
Name & Position

PERSONAL REFERENCES

Name 1
Contact No.
Relationship
Name 2
Contact No.
Relationship

BUSINESS AND WORK EXPERIENCE

Have you ever operated your own business ?
YesNo
If Yes, give details
Do you understand Franchising and Licensing Services ?
YesNo
Have you ever been bankrupt ?
YesNo
Is any legal action pending against you ?*
YesNo
If Yes, give details*
Do you have any criminal convictions ?*
YesNo
If Yes, give details*

PREVIOUS WORK EXPERIENCE (List most recent first)

Employer 1
Position
Contact Phone
Time Employed
Reason for leaving
Employer 2
Position
Contact Phone
Time Employed
Reason for leaving
Employer 3
Position
Contact Phone
Time Employed
Reason for leaving

EDUCATION

Please detail education you have undertaken :

SECONDARY EDUCATION

Course
Grade Achieved
Academic Institution
Dates
Subjects

TERTIARY EDUCATION

Course
Grade Achieved
Academic Institution
Dates
Subjects
Other Relevant Qualifications
Describe Your Strengths*
How do you apply them in Business ?
Reason of Self-employment / Franchising ?
What is the state of your Health ?
When are you available to Start ?*
Allocated Capital to invest in this Business ?*
How would you Fund this Business Investment ?*
I/we accept Geowash Non Disclosure Agreement Terms and Conditions.*

X

CONFIDENTIALITY NON-DISCLOSURE AGREEMENT GEOWASH

In consideration of this Agreement by Geowash to provide me/us confidential information and disclose intellectual property in relation to the business, the Franchise system, methods and/or products I/we hereby agree as follows:-

I/we the undersigned will not disclose, communicate or divulge to any other person, business or corporation?any confidential information, knowledge, know-how and or intellectual property concerning the products, business systems, methods of operation of the said systems or any other matter concerning the business of Geowash which may be communicated to me/us by virtue of exposure to any papers, email, information and or by way of direct voice to voice communication or by any other means.

I/we shall not at any time before or hereafter use, copy, imitate or disclose either for my own benefit or the benefit of others, whether for profit, advantage or any other purpose, any such confidential information, data, knowledge or know-how in any manner, shape or form whatsoever other than in the secured operation of a Geowash Franchise under the terms and conditions of the Geowash Franchise Agreement..

The restriction contained herein shall continue to apply endlessly and or after the expiry or cessation of any Franchise agreement or deed or contract without the limit of time, regardless of how such expiry or cessation came about.

Any breach of this undertaking shall cause irreparable harm to Geowash or the Franchise system of the company and therefore in the event of a breach or threatened breach of the provisions of this Confidentiality Non Disclosure Agreement, Geowash shall be entitled to an immediate injunction restraining me/us from using, disclosing or appropriating in whole or in part the confidential information or from rendering any services to any person, business or corporation to whom such confidential information has been disclosed or is threatened to be disclosed. Nothing herein shall be construed as prohibiting Geowash from pressing any other remedies available for such breach or threatened breach, including recovery of damages.