The information you provide will be held in the strictest confidence and completion of this

form in no way constitutes a commitment to Bin Blasters Franchising LLC or that a franchisee applicant will

be automatically awarded. We encourage you to share any relevant information and include

anything that you find will make your candidacy stand out as a potential franchisee.

Full Name *

Address *

Email *

Please describe your current business or employment responsibilities *

Current occupation of your proposed operations team *

Have you ever been convicted of a Felony? *

Yes

If yes, please explain

Describe any lawsuits that you have been involved in and the nature of the lawsuits. *

Have you or anyone on your ownership team ever filed for bankruptcy? Include date filed and date discharged *

Do you have any experience running a home service business? If yes, please describe your experience. Time involved, duties, business type, current status. *

Do you or any persons related to you have any connection with any other bin cleaning businesses? If yes, please describe your relationship and the name of the business. *

(All information provided is strictly confidential and will be treated as such)

Financial Details

Salary amount

Total Monthly Income

Total Monthly Expenses

Cash on hand and in banks

Net Worth

Additional Questions

Assuming your review of Bin Blasters is positive, what is your desired time frame to open a franchise? *

Describe any training/experience in sales, marketing, management or entrepreneurship *

Why do you think a Bin Blasters franchise will enable you to reach your personal goals? *

Area / Location Preference *

1.
2.
3.

Who will be responsible for daily operations? *

Amount of cash available for investment *

Source of cash for investment *

Will this business be your sole source of income? *

What questions do you have about this opportunity? *

Authorization for Investigation

I/We represent and warrant that all of the statements made by me/us in the above application are true and correct. I/We understand that if I/we make a false statement, such action will terminate my/our application for consideration. I/we understand that by signing this application, I/we authorized Bin Blasters to check my/our credit with a credit bureau, conduct a background and criminal investigation and conduct whatever investigation as permitted under the Fair Credit Reporting Act (FRCA). I/We agree that this application shall be and remain the property of Bin Blasters. Whether or not this application is approved. By my signature below, I herby authorize all corporations, former employers, credit agencies, educational institutions, law enforcement agencies, city, state, county and federal courts and agencies, military services and persons to release all information they may have about me including criminal and driving history. This authorization shall be valid in original or copy form. I/We understand that this application does not obligate either party to engage in a business transaction in any matter

Applicants signature (type full name) *

Date *

Date of birth *