G LOBAL B USINESS D EVELOPMENT全球商业发展REQUEST FOR CONSIDERATION FORM加盟合作申请意向表The information requested in this form is used to evaluate your qualifications to be awarded a Papa John’s franchise. (Please print or type your responses.)该表所要求填写的信息用以评估是否具备加盟棒！约翰的资格。
（请打印表格内容）PERSONAL DATA个人信息Name: Date of Birth:姓名：出生日期：Social Security, Passport or Country ID Number: ______________________________________________________ 社保号、护照号或身份证号：Address: ______________________________________________________________________________________ 地址：State, Country, Zip Code: Citizenship:国家省份邮编：国籍：Email Address: _________________________________________________________________________________ 电子邮件地址：Home Telephone: _________________________________ Business Telephone:家庭电话：单位电话：Mobile Telephone: _________________________________ Facsimile:手机：传真：Marital Status: _________________________________ Spouse’s Name:婚姻状况：配偶姓名：What specifically drove you to contact Papa John's at this time? (Please be specific as to the exact newspaper, magazine, etc.)这一次是什么促使您联系棒！约翰？（请注明报纸、杂志等名称）Area(s) of Interest: Number of Units You Wish to Develop:有意向的区域：希望开设店铺数量：1. ______________________________________ ________________________________2. ______________________________________ ________________________________BUSINESS EXPERIENCE商业经验Please list present or most recent company information.请列举目前或最近公司信息。
Company Name:公司名称：Type of Business:企业类型：Address:地址：Papa John’s International, Inc.Request for Consideration FormPage Two棒！约翰国际有限公司加盟合作申请意向表第2页Present / Most Recent Position:目前/最近职位：Dates Position Held:任职日期：Number of People You Directly Manage:直接管理人数：Previous Positions:之前职位：Have You Ever Owned a Business? Yes No是否曾经拥有过一家企业？有无If Yes, What Type of Business?如果有，是什么企业类型？Do You Plan to Devote Full Time to This Business Venture? YesNo您是否计划全职经营这次商机？是否Will You Have Equity Partners? Yes No您是否有股东合伙人？是否(If yes, please identify all partners in the Business Structure section of this form.)（如果是，请在本表格的商业结构栏中写明所有合伙人。
）Why do you believe you can successfully operate a Papa John’s franchise in your area(s) of interest?您为何认为自己能够在所意向区域成功经营棒！约翰？愿意提供用来评估申请意向表的其他信息：Are you now, or have you in the previous ten years, been a YesNoparty to any lawsuit, arbitration, mediation, bankruptcy orother legal proceeding?您目前或在前十年内是否参与任何诉讼、裁决、调解、破产或其他法律诉讼？是否If yes, please provide details:如果是，请提供细节：____________________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________ Have you ever been convicted of a felony? YesNo您是否曾犯有重罪？是否If yes, please provide details:如果是，请提供细节：Papa John’s International, Inc.Request for Consideration FormPage Three棒！约翰国际有限公司加盟合作申请意向表第3页PERSONAL FINANCIAL STATEMENT个人财务报告Total Assets:总资产：Total Liabilities:总债务：Net Worth:资产净值：Papa John’s International, Inc.Request for Consideration FormPage Four棒！约翰国际有限公司加盟合作申请意向表第4页PROPOSED COMPANY STRUCTURE规划公司结构A.Proposed Owner(s):计划所有者：Name: Address: Social Security Number: Active in Franchise?姓名：地址：社会保险编号：目前是否有特许经营？1.__________________________________________________________________________________________2.__________________________________________________________________________________________3.__________________________________________________________________________________________B.Proposed Principal Operator:建议主要经营者：Name: Address: Social Security Number:姓名：地址：社会保险编号：C.What will be your company’s organizational structure (e.g., Partnership, Corporation, LLC, etc.)?您将采取何种公司结构（如合伙公司、股份有限公司、有限责任公司等）？D.If lender financing, please name specific resources:如贷款，请注明贷款来源：E.Please attach a resume or C.V. and financial statement for each proposed owner and your Principal Operatorcandidate.请附上每位计划所有者和主要经营者申请人的简历和财务报表。
ACKNOWLEDGEMENT确认By signing and submitting this form to Papa John's International, Inc., you hereby authorize Papa John's International, Inc. and or it's agent to perform background checks including obtaining your consumer credit report from a credit reporting agency. Your signature also authorizes, without reservation, any agencies contacted to furnish your consumer credit information and release all parties involved from any liability and responsibility for doing so. This authorization and consent shall be valid in an original, fax, photocopy or digital image form.签署并向棒！约翰国际有限公司递交此表格，即授权棒！约翰国际有限公司及/或其代理机构授权对您进行背景调查，包括从征信机构获得消费信用报告。