Short Introduction Form

Please take the time to fill in the Short Introduction Form so that we can quickly determine if Mad Mex is the right business for you.

This form is not a formal application to be considered for a Mad Mex franchise. With the exceptions of confidentiality, this is not an agreement to proceed or purchase a Mad Mex franchise, but it is an indication that you are serious about learning more about our opportunities.

Please Introduce Yourself

First Name: Last Name: Address: Town/City: State: Postcode: Telephone (Home): Telephone (Work): Mobile: What is the best time to call you? Email address: Confirm Email address: Age last birthday: What is your current occupation or business?

Are you a citizen or permanent resident of Australia? Yes No

If not, what is your status to work in Australia: Family Partner name: Number of children: Age of children: Will other members of the family work with you? If you plan to have any other partners in the business apart from your family, then please list their names and relationship to you: Required Field

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Your Funding Position

(Please advise approximate values) 1. Cash funds available to you: 2. Market value of any real estate: 3. Amount of total debts you have:

Where would you like your franchise?

Are you looking to purchase an existing Mad Mex franchise or a previously advertised opportunity?
Please list the locations you may be interested in: If you would like us to work with you to find an opportunity in a location of interest to you, then please complete the following: 1. Which state/s are you interested in: 2. Which city or suburbs are you particularly interested in: 3. In what area or suburb would you ideally like your franchise located?: Required Field

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Your Declaration

We want to be able to share as much information as possible with you to help you assess if Mad Mex is right for you, to enable us to do this we ask you complete the following declaration. You may choose not to at this point however it will restrict some of the information including sales data that we can provide at this initial stage of your enquiry. I/we: Of: I/we have answered the questions and provided the information in this form and any other forms supplied, to the best of my/our knowledge and belief, and that as far as I am/we are aware the answers and information are true and correct in all respects, and that no relevant details have been omitted. I/we acknowledge that any information provided to me by Mad Mex may contain items that are commercially sensitive and confidential. I/we agree to keep all information confidential and not to share with any one other than any professional advisors required to assist us in assessing the franchise opportunity. If requested by Mad Mex we will immediately return or destroy all information supplied by them. I/we will not rely solely on information supplied by Mad Mex in assessing any franchise opportunity and will make our own investigations. Applicant 1 name: Applicant 2 name (if applicable): We will be contacting you shortly to discuss this introduction and discuss any opportunities with Mad Mex that interest you. When we call, what is the most important question you would like us to answer immediately?

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← Go to page Please enter your first name.
← Go to page Please enter your last name.
← Go to page Please enter your address.
← Go to page Please enter a town or city.
← Go to page Please enter a state.
← Go to page Please enter a postcode.
← Go to page What is your telephone number?
← Go to page Please enter your mobile number.
← Go to page Please nominate a best time to call.
← Go to page Please enter a valid email address.
← Go to page Please confirm your email address.
← Go to page How old are you?
← Go to page What's your current occupation?
← Go to page Will you be working alone?
← Go to page List the names of other partners in the business.
← Go to page Why do you want your own business?
← Go to page What type of business have you owned?
← Go to page Please list your employment history or training qualifications.
← Go to page Why does a franchise appeal to you?
← Go to page What cash funds are available to you?
← Go to page What is the market value of any real estate?
← Go to page What is the amount of total debts you have?
← Go to page What locations are you interested in?
← Go to page Which state/s are you interested in?
← Go to page Which city or suburbs are you particularly interested in?
← Go to page In what area would you ideally like your franchise located?
On this Page Please enter your declaration.
On this Page Please nominate where you are declaring from.
On this Page Please sign your name.
On this Page Please tell us what you'd like us to answer immediately.

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