Franchisee Evaluation Form

In addition to requesting additional information, this application is used for purchasing a new franchise, an additional franchise, or the purchase and transfer of an existing store. The filing of this form does not obligate the applicant to purchase or the franchisor to sell a franchise or location. Complete in full and do not use abbreviations. Please print clearly or type.
  • Business Information

  • Financial Information

  • Investors

  • Full Name, Active/Silent, Ownership %
  • Full Name, Active/Silent, Ownership %
  • Full Name, Active/Silent, Ownership %
  • Full Name, Active/Silent, Ownership %
  • Disclaimer

    I understand that the granting of a franchise is at the sole discretion of the Franchisor (GB PIZZA EXPRESS). For any franchise to be located outside of Malaysia, I understand that I must provide the requisite photo identification to the Franchisor to verify my identity prior to any sale or transfer and upon request during the term of any franchise agreement entered into with the Franchisor. I understand that any information I receive from the Franchisor or from any employee, agent or franchisee of the Franchisor or its affiliate is highly confidential ("Confidential Information"), has been developed with a great deal of effort and expense to the Franchisor, and is being made available to me solely because of this application. I agree that I shall treat and maintain all Confidential Information as confidential, and I shall not, at any time, without the express written consent of the Franchisor, disclose, publish, or divulge any Confidential Information to any person, firm, corporation or other entity, or use any Confidential Information, directly or indirectly, for my own benefit or the benefit of any person, firm, corporation or other entity, other than for the benefit of the Franchisor. I authorise the Franchisor or its designee to procure an investigative consumer report, a general background search and an investigation in accordance with anti-terrorism legislation. I understand that these Investigations may reveal information about my background, character, general reputation, mode of living, association with other individuals or entities, creditworthiness, litigation history and job performance (collectively referred to as “Investigation Data”). I understand that, upon written request, within a reasonable period of time, I am entitled to additional information concerning the nature and scope of these Investigations. I hereby release any representative of the Franchisor or its affiliate, a credit bureau, security consultant or other investigative service provider selected by the Franchisor, its affiliates, officers, agents, employees, and/or servants (collectively referred to as the “Investigator”) from any liability arising from the preparation of these Investigations. This authorisation for release of information includes but is not limited to matters of opinion relating to Investigation Data. I authorise all persons, schools, companies, corporations, credit bureaus, law enforcement agencies or other investigative service providers to release such information without restriction or qualification to the Investigator. I voluntarily waive all recourse and release them from liability for complying with this authorisation. This authorisation/release shall apply to this as well as any future request for these Investigations by the above named individuals or entities. I authorise that a photocopy or facsimile of this release be considered as valid as the original. Everything that I have stated in this application is true and I understand that the information provided by me will be relied upon by the Franchisor. In accordance with anti-terrorist legislation, I understand that I will not be approved to purchase a franchise if I have ever been a suspected terrorist or associated directly or indirectly with terrorist activities. I read, understand, and agree to all of the above. Additionally, I understand that the Franchisor may require me to pass a standardised Math and English exam. I understand that I will be required to provide the Franchisor with copies of my bank statements for the past three (3) months as verification of the liquid assets listed in the my financial statement submitted to the Franchisor. 2018
  • Signature

  • MM slash DD slash YYYY
  • It is recommended that you print a copy of this application for your records before clicking the "Submit" button.