Application - Pure Nectar Juice

Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Guests? community mindset?

Applicants

Please list all principals who involved in the business.

Applicant 1

First

Last

Phone

Applicant 2

First

Last

Phone

Applicant 3

First

Last

Phone

Financial Confirmation

I confirm that we have the ability to make an investment of US$ 200,000 – US$ 225,000.

Amount of cash and credit facilities:

Confirmation

By entering in my name in the e-signature box, I confirm that the information provided on this form is true and accurate. I understand that providing this information does not obligate me to become a PURE NECTAR franchisee nor does it obligate PURE NECTAR to grant us a franchise.

This information is being provided to begin a serious dialogue to explore the feasibility of my becoming a PURE NECTAR Franchisee. I agree to keep all information received from Pure Nectar in the strictest confidence and only for the purposes of this evaluation and no other purpose.

E-Signature

Date

Check Your Eligibility

Start Your Evaluation

Answer All Questions Below

Applicants

Confirmation