Mr Whippy Franchise Application Form Privacy StatementTo apply for the purchase of a franchise, you need to agree with the following privacy statement: Mr Whippy Pty Ltd complies with the Privacy Act. The personal information we collect from you can be accessed by you on your request. The personal information that we collect from you will be used for the purpose of assessment and selection of your application against suitable opportunities including, but not limited to, the opportunity that you have submitted an application for. Your personal information is stored in a secure database and used for recruitment and selection only. The purpose of this application is for informational purpose only. It does not bind you or any of our brands in any way. If you choose to submit an application for a franchise, you will be deemed to have accepted our Privacy Statement. If you would like to discuss the privacy of your personal information on our Privacy Statement, please contact our Privacy Officer on firstname.lastname@example.orgDo you agree to the terms of the Privacy Statement?* I Agree Contact InformationFirst Name*Surname*Email Address* Residential Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Mobile*Personal InformationCurrent Occupation*Do you rent or own your home?*OwnRentIf own, estimate valueIf own, amount owed on mortgage (if applicable)Estimated Net Assets*Estimated Liquid Assets (cash and assets easily saleable)*How do you intend to fund your franchise investment?*Do you suffer from any long-term physical or emotional health problems?*YesNoIf yes, please specifyHave you/your spouse/your business partners ever been convicted of a criminal offence or bankruptcy?*YesNoBusiness InformationHave you ever been self employed?*YesNoIf yes, please provide detailsHave you ever been involved in the retail sector?*YesNoIf yes, please provide detailsHow much time do you/your family/your business partners envisage working at the business? Please indicate in percentage.*What Australian state is your preferred business location**Australian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaVictoriaWestern AustraliaTasmaniaIf you have a preferred location within the above state, please indicate.*Authorisation to Submit FormThe information that you have provided in this application will be treated as Commercial in Confidence and will not be made available to any party. The purpose of this application is for information purposes only. It does not bind you to Franchised Food Company in any way. By selecting the 'submit' button below, you confirm that this information is true and complete. This iframe contains the logic required to handle Ajax powered Gravity Forms.