Franchise Application

Thank you for your interest in opening a Vintner's Circle winemaking franchise.

This page is secure and this application is kept confidential. If you prefer, download our PDF Application, print, and mail to us. Or fax the application to 866-653-2045.

First Name:	*
Last Name:	*
E-Mail Address: (example: )	*
Street Address:
City:
State/Province:
Zip Code:
Daytime Phone:
Evening Phone:
Cell Phone:
Fax Number:
Best time to contact?
Age:
Are you a U.S. Citizen?	Yes No

Occupation:
Employed by:
Years at present occupation?
Spouse's Name:
Spouse's Employer:
Have you ever been convicted of a felony?	Yes No
If so, for what?
Do you currently own, or have you ever owned, your own business?	Yes No
If so, describe your business(es):
Have you ever failed in business?	Yes No
If so, describe why:
Do you have any experience (other than a customer) with Vintner's Circle?	Yes No
If yes, please briefly describe:
Do you have prior experience in the bar or restaurant industry?	Yes No
If yes, please briefly describe:
Do you have prior experience in the wine industry?	Yes No
If yes, please briefly describe:

Do you expect to have a business partner or other equity partners?	Yes No
If yes, please briefly describe who he/she is, your relationship, and whether he/she will be a financial partner and/or an operational partner:
Please provide two business and two personal references. These people should not be family members. Please include contact information for these individuals:

What areas or locations would you like to consider for establishment of a Vintner's Circle franchise? Please note areas in order of preference:
Do you plan to pursue other business interests while operating your Vintner's Circle franchise? If so, please briefly describe the other business you will persue:
Would you be interested in opening more than one franchise at this time?
If awarded a franchise, would you manage it full-time? If not, who would?
How did you learn of Vintner's Circle franchise offering?
What questions do you have about the Vintner's Circle franchise offering?

What is your approximate net worth?	$
How much capital do you have available for investment?	$
What will be your source of funds and will you need to secure financing for some or all of your investment?
Have you ever failed in business or filed bankruptcy?
How soon are you able and willing to acquire a franchise?

By submitting this Confidential Application, I/We do hereby certify that the above information is a true and accurate description of my/our financial and personal position. In supplying the foregoing information and references, I/We do so with the understanding that Vintners Circle Franchising LLC may, through its agents or employees, verify this information regarding my/our character, reputation, personal characteristics and financial data. I/We give Vintners Circle Franchising LLC authorization to make such inquiries of the persons or agencies listed herein and to obtain credit reports or other information from third parties to determine my qualifications.

Signature of Primary Applicant:
Signature of Partner:

Your completion of this Confidential Information Form does not obligate you to Vintner’s Circle Franchising LLC in any way. All information provided herein is confidential and will be used to help us evaluate you as a potential Vintner’s Circle franchisee. This is not a contract.

This is not an offering; a franchise offering is made by prospectus only. However, in order to get started with the evaluation and licensing process, we ask that you take some time to complete this confidential information form. Please feel free to add your resume or any other supplements to this form if you desire. After we have received and reviewed your completed form, we will contact you and provide you with additional and appropriate information relative to your interest and we will outline what additional information we will need from you, if any.


Fields marked with a * are mandatory.