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Why a franchise

PLEASE READ THIS FIRST:

The Bad Ass Coffee Company has two options on this web site to fill out the Franchise Application, the options are listed below.

Option #1: Download the franchise application to your desktop, manually fill out the application and FAX it back to the Corporate office. You must CLICK the "Download Application" button below to effectively download. If your computer does not already have the Adobe Acrobat software click the "Get Adobe software" button below. After you have installed the software then click the "Download Application" button again.

Option #2: Fill out the Franchise Application form online using the Interactive Online form. You will find that form by scrolling down this page. Once all of your information is completed you will submit the information to the Corporate office by simply clicking the "SUBMIT" button at the end of online application.

Note: Do not print out the Interactive Online Application form as a substitute for the Downloadable version of the Application. The Interactive Online form is not formatted for hard copy use.

DOWNLOAD THE APPLICATION.
You will need the FREE Adobe Acrobat reader to view this, you can download it here:



The Bad Ass Coffee Co.™ will use this report to help evaluate your qualifications for a franchise.
THIS IS CONFIDENTIAL INFORMATION AND IS NOT A CONTRACT
OFFERING BY CIRCULAR ONLY

THE BAD ASS COFFEE COMPANY™ OF HAWAII, INC.
155 West Malvern Ave.
Salt Lake City, Utah 84115
(801) 463-1966  *  Fax (801) 463-2606  *  Toll Free 1-(888) 422-3277

FRANCHISE APPLICATION - SECTION 1
You may print out this page and fax it to: 801-463-2606

FRANCHISE
APPLICANT		 First Name:
 Middle:
Last:
Date of birth: (mm/dd/yy)
FRANCHISE
SPOUSE		 First Name:
 Middle:
Last:
Date of birth: (mm/dd/yy)
PRESENT
ADDRESS		 Years & Months:
 Street Address:
 City:
 State:

 Zip:
 Telephone:
PREVIOUS
ADDRESS		 Years & Months:
 Street Address:
 City:
 State:

 Zip:
 Telephone:
PREVIOUS
ADDRESS		 Years & Months:
 Street Address:
 City:
 State:

 Zip:
 Telephone:
Have you ever been in business for yourself ?
-NO      -YES
If Yes, Please explain:
Has your spouse ever been self-employed ?
-NO      -YES
If Yes, Please explain:
Have you or your spouse had any serious illnesses or accidents within the last ten (10) years ?
-NO      -YES
If Yes, Please explain:
Have you ever been in business for yourself ?
-NO      -YES
If Yes, Please explain:
Highest Education Level Achieved: -8 | -9 | -10 | -11 | -12 | -13 | -14 | -15 | -16 | -17 | -18
Major:
SPOUSE Highest Education Level Achieved: -8 | -9 | -10 | -11 | -12 | -13 | -14 | -15 | -16 | -17 | -18
Major:
Have you or your spouse ever been convicted of something other than a minor traffic violation ?
-NO      -YES
If Yes, Please explain and include date, location, charge and disposition of charge:
Are you or your spouse subject to pending litigation or unjustified judgements ?
-NO      -YES
If Yes, Please explain:
Do you have children ?
-NO      -YES
Ages:
Business Experience / Employment History
List all history beginning with present or most recent employer.
FRANCHISE APPLICANT:
Employer's Name:
 Telephone:(xxx-xxx-xxxx)
Street address:
City:
 State:
Zip:
Job title/Description :
Supervisor's Name:
 May we contact your employer ?:
-YES -NO
Date of Employment:
From: To: 		Salary Per Month:
Begin: End:
Reason for leaving:
Employer's Name:
 Telephone:(xxx-xxx-xxxx)
Street address:
City:
 State:
Zip:
Job title/Description :
Supervisor's Name:
 May we contact your employer ?:
-YES -NO
Date of Employment:
From: To: 		Salary Per Month:
Begin: End:
Reason for leaving:
Employer's Name:
 Telephone:(xxx-xxx-xxxx)
Street address:
City:
 State:
Zip:
Job title/Description :
Supervisor's Name:
 May we contact your employer ?:
-YES -NO
Date of Employment:
From: To: 		Salary Per Month:
Begin: End:
Reason for leaving:
APPLICANT'S SPOUSE
Employer's Name:
 Telephone:(xxx-xxx-xxxx)
Street address:
City:
 State:
Zip:
Job title/Description :
Supervisor's Name:
 May we contact your employer ?:
-YES -NO
Date of Employment:
From: To: 		Salary Per Month:
Begin: End:
Reason for leaving:
Employer's Name:
 Telephone:(xxx-xxx-xxxx)
Street address:
City:
 State:
Zip:
Job title/Description :
Supervisor's Name:
 May we contact your employer ?:
-YES -NO
Date of Employment:
From: To: 		Salary Per Month:
Begin: End:
Reason for leaving:
Employer's Name:
 Telephone:(xxx-xxx-xxxx)
Street address:
City:
 State:
Zip:
Job title/Description :
Supervisor's Name:
 May we contact your employer ?:
-YES -NO
Date of Employment:
From: To: 		Salary Per Month:
Begin: End:
Reason for leaving:

FRANCHISE APPLICATION - SECTION 2

Will other investors participate in this franchise
-YES -NO
If Yes, list name and extent of participant
Briefly describe your plans for managing this franchise:
Will you be interested in purchasing multiple units ?
-YES -NO

ENTITY / PERSONAL STATEMENT

ASSETS
Cash on hand in bank:
$
U.S. Government Securities:
$
Accounts, Loans and Notes receivable:
$
Cash Surrenderr Value of Life Insurance:
$
Stocks:
 $
Real Estate Home
 $
Real Estate Other
$
Automobiles:
 $
Other Assets (ITEMIZE)
 
$
$
$
$
$
TOTAL ASSETS :
$
LIABILITIES
Secured Notes Payable to Banks
 $
Unsecured Notes Payable to Banks
$
Notes Payable to Relatives
$
Accounts and Notes Payable to Others
$
Rents and Interest Due
$
Taxes Due
$
Liens on Real Estate
$
Auto Loan(s)
$
Charge Accounts (ITEMIZE)
 
$
$
$
$
$
As Endorser or Co-Maker
$
On Leases or Contracts
$
Legal Claims
$
Provisions for Federal Income Tax
$
Other Special Debt
$
TOTAL ASSETS MINUS TOTAL LIABILITIES EQUAL NET WORTH: $

SOURCE OF MONTHLY INCOME
Salary:
 $
Bonuses or Commissions:
$
Dividends or Interest:
$
Real Estate Income:
$
Other:
 $
Other Income (ITEMIZE)
 
$
$
$
Total Income:
$
The Difference Between Income and Expenses:
$
Amount of Cash Available for Franchise:
$
MONTHLY EXPENSES
Rent or Mortgage Payment
$
Food and Utilities:
$
Incidentals:
 $
Auto Loan(s):
 $
Medical:
 $
COMPANY NAME
BALANCE DUE
PAYMENT
$
$
$
$
$
$
$
$
TOTAL EXPENSES:
$
SOURCE OF FUNDS:
SAVINGS-$
OTHER-$
BANK LOANS- $

FRANCHISE APPLICATION - SECTION 3 - REFERENCES

NAME:
 ADDRESS CITY STATE ZIP OCCUPATION TELEPHONE YEARS KNOWN

BANK_CREDIT_REFERENCES

Check one: LLC-      CORPORATION-      SOLE PROPRIETORSHIP-      INDIVIDUAL-
ACCOUNT NAME OF BANK AND STREET ADDRESS CITY STATE ZIP
SAVINGS: