Personal Information

Previous Business Information

Personal and Credit References

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Please list at least three personal and three credit references, other than close relatives. Along with names and addresses of your personal references, you should include a brief description of you affiliation with this individual, his or her title or position and mention the length of your association. The banking reference should represent the same accounts that you provide on the following Financial Statement. We will use these banking references to confirm your current assets and financial situation.

Personal Reference

Banking or Brokerage Reference

In submitting this completed form, it is understood that I am under no obligation, but that Ambiance Day Spa. will provide more information on the opportunities available for a qualified individual to become a franchisee. I am interested in having my own business. If a review of the information indicates I have the qualifications to become a franchisee, I understand a one-day personal meeting may be required in Downtown TORONTO for a review of the requirements and opportunities. This section must be filled out as complete as possible.

Financial Information

Assets

Liabilities

Legal Information

Sole Proprietorship Business Partner

Please have them fill out a separate application.

Franchise Information

Authorizations and Releases

I understand that Ambiance Day Spa. will be requesting information from various companies, financial and other institutions, credit reporting agencies, professional and academic certification law enforcement agencies, former employers, and the military, and I hereby authorize such entities to release any information that they may have about me to Ambiance Day Spa. and its agents and designees, and release them from any liability arising out of or related to their release of such information.

I authorize all financial institutions holding funds or other property on my behalf or on behalf of any business entity in which I hold a beneficial interest, whether or not identified in this Franchise Application, to release all records including signature cards, statements and all documentation reflecting or wire the source of deposited funds, whether the funds were received in the form of cash, credit, electronic fund transfer.

I also authorize Ambiance Day Spa. and its agents and designees to obtain such credit and other civil and criminal investigative reports as they consider necessary to evaluate this Franchise Application, and under-stand that these reports may contain information about my background, mode of living, character and personal reputation. This authorization is valid for any current and future reports and updates that may be requested.

I request a copy of my credit report I do not request a copy of my credit report

I further authorize Ambiance Day Spa. and its agents and designees to contact individuals or entities identified in this Franchise Application, or whose names arise in connection with the civil and criminal investigative reports described above for purposes of obtaining character references and verifying the information contained in this Franchise Application. I hereby authorize any individual or entity contacted by Ambiance Day Spa. or its agent or designee to provide all requested information, and release them from any liability arising out of or related to their release of such information.

Representations

I certify that I have carefully read the Franchise Application and it is complete, true, and correct in all respects. I have been advised and understand that any misrepresentation or inaccuracy in the information provided by me will be grounds for termination of any franchise that Ambiance Day Spa. may grant to me based on the information in this Franchise Application. Not withstanding this acknowledgement, I understand and agree that nothing contained in this Franchise Application obligates Ambiance Day Spa, to grant me a franchise.

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