Panchai Franchise Application Form

The following information is the basis for a preliminary franchise application. The submission of this application does not obligate Pan Chai or Malaysian Restaurants Management Ltd in any way or manner.

Personal Information (All fields required)

Title:*
First Name:*
Last Name:*
Home address:*
City:*
Country:*
Postcode:*
Date of birth:*
Email address:*
Day time tel no.:*
Mobile no.:
Country of residence:*
Nationality:*
Have you any criminal convictions or its equivalent?*
Has a judgment/lien/bankruptcy been filled against you or have you been involved in any litigation proceedings with the last 5 years?*

Business Experience (All fields required)

Are you currently an employee or owner of an existing business (please give details)*
No. of years employed:*
Type of business:*
Name of company:*
Position Held:*
1st Line of address:*
City:*
Country:*
Postcode:*
Day time tel no.:*
Has any business with which you have been associated been adjudicated or bankrupt?*

Financial Information (please list all figures in GBP)

Do you have the minimum liquid cash/unencumbered cash of £150,000 required?*
Income from current occupation:*
Income from other sources:*
Please explain other income:*
Individual liquid assets (cash, stocks etc.):*
Individual fixed assets (home, car, etc.):*
Individual total assets:*
Individual liabilities (mortgages, loans, etc.):*
Your individual total net worth:*
Is there other financing not included in above? If so please specify the amount:*

Partners

(all partners must fill out a separate application and be name on any Franchise Agreement executed

First Name:*
Last Name:*
First Name:*
Last Name:*
First Name:*
Last Name:*

Other information

1. In what city would you like to open your Pan Chai restaurant in? Why chose that location?*
2. What involvement do you or your family expect to have in the business? (operator or investor)*
3. Are you or have you been a franchisee or licensee of any other organisation*
4. How did you hear about franchising opportunities with Pan Chai*
*Enter Code:**