Candidate Qualification Questionnaire

Franchising with Silbar Security

Please complete this summary for an evaluation of your qualifications to become a Silbar Security franchisee.

This is NOT an application or contract. Please allow yourself at least 15 minutes to complete this questionnaire.

Personal Information

Full Name (First, Middle, Last) *

Date of Birth *

Street Address *

City *

State *

ZIP/Postal Code *

Residence *

US Citizen *

Phone Number *

Phone Type *

Best Time to Call *

Email Address *

Marital Status *

Are you related to anyone at Silbar Security? *

Your Interest

How did you originally hear about Silbar Security franchise?

What is your preferred geographic market location(s)?

Preferred Location *

City and state

Secondary Location

City and state

Are you interested in a single location or multiple locations? *

Any additional details to share?

Employment History

List your last three employers (including self-employment) starting with the current one first

Employment History 1

1. Job title *

1. Organization *

1. Location *

1. Employment Type *

1. Highest Salary

1. I currently work here *

1. Start Month *

1. Start Year *

Employment History 2

2. Job title *

2. Organization *

2. Location *

2. Employment Type *

2. Highest Salary

2. I currently work here *

2. Start Month *

2. Start Year *

Employment History 3

3. Job title *

3. Organization *

3. Location *

3. Employment Type *

3. Highest Salary

3. I currently work here *

3. Start Month *

3. Start Year *

Education

High School

Name of High School

City / State

Years Attended

Did you graduate?

Degree / Diploma

College / University

Name of College / University

City / State

Years Attended

Did you graduate?

Degree / Major

Other (Trade School, etc.)

Name of Institution

City / State

Years Attended

Did you graduate?

Degree / Certification

Personal References

Please provide three professional references who are not related to you.

Reference 1

Full Name *

Relationship *

Company *

Phone Number *

Email Address *

Reference 2

Full Name *

Relationship *

Company *

Phone Number *

Email Address *

Reference 3

Full Name *

Relationship *

Company *

Phone Number *

Email Address *

Military Experience

If you have military experience please complete the following.

Enlistment Status

Branch

Rank, and Years Served

Do you have a DD-214?

Law Enforcement / Security Experience

Agency / Company Name

Years of Service

Title / Duties

City, State, Telephone No. w/ Area Code

Reason for Leaving

Agency / Company Name

Years of Service

Title / Duties

City, State, Telephone No. w/ Area Code

Reason for Leaving

Agency / Company Name

Years of Service

Title / Duties

City, State, Telephone No. w/ Area Code

Reason for Leaving

May we contact the above Agencies/Company?

Financial / Personal

Each party involved must submit this form, referencing the required liquid capital and verification of funds.

Income Per Year From Current Occupation ($) *

Spouse’s Income ($) (If Applicable)

Amount of Capital Available for Investment ($) *

Statement of Financial Condition *

Assets

Cash on Hand in the Bank ($) *

Value of Real Estate Owned *

Marketable Securities *

Automobiles *

Personal Property *

Notes Receivable *

Retirement Fund *

Profit Sharing *

401K *

Other Assets (Itemize)

Liabilities

Notes Payable *

Mortgage *

Credit Cards *

Other Obligations (Itemize) *

Total Liabilities *

Total Assets *

Net Worth *

1. How do you intend to finance this franchise? *

SBA - Small Business Administration Loan Traditional Bank or Personal Loan Investment from Business Partners 401K Roll Over Franchisor Financing No loan needed. I am fully funded. Other

2. What will be your largest obstacle in opening this Franchise? *

3. What is your current monthly cost of living? *

4. Will this franchise be your only source of income? *

5. Have you ever been convicted of a misdemeanor or felony?

6. Have you ever owned your own business? If so, please elaborate. Name of company, dates owned, type of business, how many employees: *

7. Do you have an understanding or experience with labor-based industries? *

8. Have you ever looked into a franchise before? If so, which brand(s)? *

9a. What has been your greatest business or personal accomplishment? *

9b. What has been your greatest business or personal disappointment? *

10. What are your greatest strengths and skills? *

11. Are you on track to reaching your personal and financial goals for retirement? *

12. What do you want to accomplish with this franchise? *

13. This opportunity requires full-time, hands-on involvement in daily operations and does not permit absentee ownership. Are you willing and able to meet this requirement? Please describe how you plan to be involved in the day-to-day operations. *

Please checkmark to agree to the following

Acknowledgement *

I certify that the information supplied on this form and any supporting documents I provide are true and correct and will be verified by a credit and background investigation. A credit and background check will be conducted at a later date. By completing this form, it is understood and acknowledged that I am under NO obligation and this information is provided to assist in evaluating my personal, professional, and financial qualifications as a prospective franchisee. I understand that you may check my credit history and do a background check as a part of this process and hereby give my permission to do so.

Confidentiality & Non-disclosure Agreement *

In order to protect any and all proprietary information, trade secrets, financial information or any other information provided to you (“Participant”). Silbar Franchise Group Corporation (hereinafter referred to as “SFGC”) requires all Participants and Owners to sign and adhere to the following non-disclosure agreement. Participant(s) will not at any time or in any manner, either directly or indirectly, use for personal benefit, divulge, disclose or communicate in any manner any information or materials that is proprietary to SFGC, including the Federal Disclosure Document (FDD). The participant will protect such information and treat it as strictly confidential. The obligation of the participant not to disclose confidential information shall continue for a period of three (3) years. All information disclosed in any conversation, documentation or other presentation is considered strictly confidential.

Participant (Full Name) *

Today's Date *

Signature *