Franchise Application

Please fill out this franchise application to begin the process.

Name

First Name

Last Name

Date of Birth

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Phone

(###)

###

####

Spouse / Partner Name

First Name

Last Name

Will your spouse / partner be active in the company?

YES

NO

Employment / Business Experience -

Name of business entity -

List any additional business partners and their % of ownership -

Cash on Hand (Liquid)

$

Assets

$

Liabilities

$

Net Worth

$

How do you plan to finance this business?

Have you ever declared bankrupcy or do you have any court judgements?

Describe why you want to join Haven Hot Chicken -

Click here to acknowledge the below statement that this information is true and accurate to the best of your knowledge -

YES

By Submitting this form you confirm that the information you have provided is true and correct to the best of your knowledge. Please note this form is confidential and will be used only to assess your ability as a potential business partner.

Not An Offer To Sell a Franchise
This website and the information contained on this website is for information purposes only, is not intended as an offer to sell a franchise or a solicitation of an offer to buy a franchise. The offering of a franchise can be made by prospectus only in the form of a Franchise Disclosure Document. In the states of California, Hawaii, Illinois, Indiana, Maryland, Michigan, Minnesota, New York, North Dakota, Oregon, Rhode Island, South Dakota, Virginia, Washington, and Wisconsin we will not offer you a franchise unless and until we have complied with applicable pre-sale registration and/or disclosure requirements.

Franchise Application

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