Information Int

*(all information will be treated in the strictest of confidenc*e in accordance with United Kingdom Data Protection Act 1998 )
I would like more information about The Wheelie Bin Cleaning Service International Master Franchise opportunity. Please send me details.
Full Company Name
Contact Name
Address
City
County/State/Province
Postal/Zip Code
Country
Telephone (day)
Mobile
Fax Number
Email address
Business History Please provide details of business experience. Indicate previous or current involvement in franchising and/or customer service type businesses.

Financial Information New Company:	Indicate Capital Available: UK£'s
	Source of Capital:
Existing Company:	Please post your recent accounts to: Mr. K Lloyd, Managing Director Omni Kleen Group Limited Mwyndy Cross, Pontyclun Mid Glamorgan CF72 8PN, United Kingdom

Any Company: Names and addresses of all Directors

Owners of Company: (names and addresses and Percentage of shares held:

Should you have been subject to any bankruptcy or liquidation proceedings in any way within the last five years please give details:

Have you or your company been convicted by any court for any criminal fraud offence, or have such a case pending? If so please specify:

Current Country/Countries of Operation's)?

Desired Country/Countries of Operation for The Wheelie Bin Cleaning Company:

Indicate the number of Wheelie Bin Cleaning franchise areas you believe could sustain in you country/countries of operation's): See relevant web page for information on franchise areas

How did you see or hear of this Wheelie Bin Cleaning Master Franchise opportunity?

When could you be in a position to start the Master Franchise?

Please select one of the following:
We are definitely interested in becoming a Master Franchisee and believe that we are qualified to do so. Please arrange a meeting as soon as possible.

We are interested in becoming a Master Franchisee, but are uncertain about our qualification. Please review and give us your opinion and advice.

We are serious about finding Master Franchise business but are uncertain about this Franchise without additional information.

Please read below and tick box to confirm acceptance
It is intended that the purpose of this questionnaire is for information only and is not binding on the Franchisor. We/I confirm that all the information supplied is complete and accurate in all respects. We/I hereby authorise, for the purpose of the United Kingdom Data Protection Act 1998 and for reference purpose generally, the release to the Omni kleen Group Ltd of any information in relation to the company or my financial history that they may request.