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PERSONAL DATA

Name __________________________________________________DOB_____________ Marital Status ____ No. of Dependents ____

Address __________________________________________________________________ City _________________________________

State ____________________________________________ Zip _________________ Own? _______ Rent? _______ Years ________

Home Phone ________________________ Business Phone ________________________ Cell Phone ________________________

E-Mail _______________________________________________ Fax ______________________ Best Time to Call _______________

EMPLOYMENT/BUSINESS RECORD (We Will Not Contact Your Current Employer Without Your Approval)

Current _________________________________________________ Position ___________________________ How Long? ________

Previous ________________________________________________ Position ___________________________ How Long? ________

Business Name ____________________________________________________ Industry ____________________________________

PERSONAL REFERENCES (Please List Persons That Have Known You For Two Or More Years)

Name ____________________________________________________ Phone __________________________ Years known ________

Address __________________________________________________ City _________________________ State _____ Zip _________

Name ____________________________________________________ Phone __________________________ Years known ________

Address __________________________________________________ City _________________________ State _____ Zip _________

FINANCIAL DATA (Your Personal Financial Statement May Be Requested At Our First Meeting)

Your approximate net worth? _______________________ Name of Partner/Investor (if any) ______________________________

How will you obtain cash and/or credit to manage the investment required? Please be specific.

________________________________________________________________________________________________________________

BUSINESS HISTORY (Please Have A Resume Available At Our First Meeting)

Do you now own a franchise business? ______ Name of franchise _______________________________________________

Have you ever failed in business? ______ Compromised with creditors or filed bankruptcy? ______

Details:________________________________________________________________________________________________________

Have you ever been involved in litigation regarding your business interests? _____

Details:_________________________________________________________________________________________________________

MARKET PREFERENCE (Large Markets or Cities May Be Divided Into Smaller Territories)

First choice for your location __________________________________ Second choice ___________________________________

When do you want to begin? Now _____ 3 to 6 months _____ 6 to 12 months _____ Other ____________________________

Franchise

Application

I understand that the granting of a Franchise is at the sole discretion of the Franchisor (B.C. Pizza, Inc.).

I understand that any information I receive from the Franchisor or from any employee, agent, or franchisee

of the Franchisor 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 board of directors of the Franchisor, disclose, publish, or divulge

any confidential information to any person, firm, corporation or 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 Franchisor.

I authorize the procurement of an investigative consumer report and understand that it may contain

information about my background, character, general reputation, credit worthiness, and job performance.

I understand that, upon written request within a reasonable period of time, I am entitled to additional

information concerning the nature and scope of this investigation. I hereby release credit bureaus and

law enforcement agencies to release such information without restriction or qualification to a credit

bureau or security consultant selected by the Franchisor and B.C. Pizza, Inc. and any other officers,

agents, employees and servants. I voluntarily waive all recourse and release them from liability for

complying with this authorization. This authorization/release shall apply to this as well as any future

request for an investigative consumer report by the above named firm. I authorize that a digital copy,

photocopy or facsimile of this release be considered as valid as the original.

I agree that I will settle any and all previously unasserted claims, disputes or controversies arising out of

or relating to my application or candidacy for the grant of a B.C. Pizza Franchise from Franchisor,

exclusively final and binding arbitration in accordance with the commercial arbitration rules of the

American Arbitration Association (the “AAA”) at a hearing to be administered by the AAA to be held at

Southfield, Michigan or in such a location in the state of Michigan designated by the AAA. Such claims

include, but are not limited to, claims under federal, state, and local statutory or common law, such as

the Age Discrimination in Employment Act, Title VII of the Civil Rights Act of 1964, as amended,

including the amendments of the Civil Rights Act of 1991, the Americans With Disabilities Act, the law

of contract and the law of tort.

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. I read, understand and agree to all of the above.

Date__________________ Signature (required)____________________________________________

Please submit completed and signed document

Email: [email protected]

Mail: B.C. Pizza, Inc. P.O. Box 244, Boyne City, MI 49712

Fax: 231-582-3478