Chip's Authentic Southern Cookin' Restaurants

Real Southern...Real Good

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Daily Menus - Sandy Sprin

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Catering

Ala Carte Items

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TURKEY, TURKEY, TURKEY!

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ST. PATRICK'S DAY

Franchise Info

NEW MARKETS OPEN

INVESTMENT

APPLICATION

COST SUMMARY

REQUEST

Contact Us

INITIAL FRANCHISE/LICENSE
A P P L I C A T I O N 

*** Please allow time for application to load ****
Please note: This is not an application for a license. This application does not obligate you or the Franchisor in any way and does not constitute an agreement by which a license for a Chip's Authentic Southern Cookin' Franchise is granted.

You may submit this application electronically by clicking on the "Submit" button at the bottom of the page or print and fax to the number at the bottom of the page.


I understand that the granting of a Franchise is at the sole discretion of the Franchisor.

I understand that the information I am receiving from the Franchisor or from any employee, agent, or franchisee of the Franchisor is highly confidential, has been developed with a great deal of effort and expense to the Franchisor, is being made available to me because of this application, and will be held in strictest confidence.

I will not divulge or use any data, customer or employee names and addresses, techniques, methods, advertising materials, forms or other information of whatever kind received fro the Franchisor without its consent.

I understand that I will have to successfully complete the Franchiser’s training school before I will be allowed to open for business.

I authorize the procurement of an investigative consumer report and understand that it may contain information about my background, character, general reputation, mode of living, credit worthiness and job performance.  I understand that, upon written request within a reasonable period of time, I am entitled to additional information concerning the nature and scope of this investigation.  I hereby release VTG Hospitality Group, LLC., their officers, agents, employees, shareholders, servants and affiliated companies from any liability arising from the preparation of this report or investigation relating thereto.  This authorization for release of information includes but is not limited to matters of opinion relating to my character, ability, reputation and past performance.  I authorize all persons, schools, companies, corporations, credit bureaus, and law enforcement agencies to release such information without restriction or qualification to VTG Hospitality Group, LLC, and any of their officers, agents, employees, shareholders and servants.  I voluntarily waive all recourse and release them from liability for complying with this authorization.  This authorization/release shall apply to this as well as any future request for an investigative consumer report by the above named firm.  I authorize that a photocopy or facsimile of this release be considered as valid as the original.

I have read this application and everything I have stated in it is true and correct.  Additionally, I understand that the information provided by me will be relied upon by the Franchisor.

Personal Information

Name of Principal Applicant
Email Address
Date of Birth
Social Security #
Street Address (Resident)
Day Phone Number
Home Phone Number
City
State
Zip Code
Mailing Address (if different from above)
City
State
Zip Code
Business Background Information
(Resume or other business summary may be attached)

1.

From (Mo/Yr)
To (Mo/Yr)
Company Name
Type of Business
Self-Employed Employed
City
State

2.

From (Mo/Yr)
To (Mo/Yr)
Company Name
Type of Business
Self-Employed Employed
City
State
Have you ever owned a food franchise or food operation? Yes No
If Yes, please state details
Name of Franchisor or Food Operation
Street Address
City
State
Have you or any business entity in which you ever owned an interest been involved in bankruptcy or insolvency proceedings or compromised with creditors? Yes No
If yes, please state details

Business References

1.

Name
Street Address
City
State
Zip Code
Home Phone Number

2.

Name
Street Address
City
State
Zip Code
Home Phone Number

3.

Name
Street Address
City
State
Zip Code
Home Phone Number

Area of Interest

City / area of interest for development
(Please be as specific as possible)
Second Choice
Third Choice

General Information

If yes, please state details
Will you devote your full time to this business? Yes No
If no,please give intentions as to division of time.
Operating Partner Name
Does Operating Partner have restaurant experience?

Other parties to be involved in this business

1.

Name
Street Address
City
State
Zip Code
Home Phone Number

2.

Name
Street Address
City
State
Zip Code
Home Phone Number
Partners or associates who will join you in this venture also must submit a personal and financial questionnaire.

Personal Financial Statement

Assets
Cash on hand and unrestricted in banks $
Accounts and loans receivable (including relatives)
Notes receivable
Life insurance, cash surrender value
Stock, bonds and government securities
Real estate: Primary residence
Other
Automobile-market value
Other assets (itemize)
Total assets $
Annual Source of Income
Salary $
Spouse's salary
Bonus and commissions
Interest
Dividends
Other income (itemize)
Total $
Liabilities
Mortgages on real estate: Primary residence
Other
Notes payable to banks, unsecured
Notes payable to banks, secured
Notes payable to others(including relatives)
Interest payable
Loans against life insurance
Accounts payable (monthly)
Federal or state taxes and assessments payable
Other liabilites (itemize)
Total assets $
Total liabilities $
Net worth $
Contingent Liabilities
Legal claims $
Guarantor or comaker
Leases or contracts
Other special debts, or liens, etc.
General Information
Are you defendant in any suits or legal action? Yes No
If Yes, please explain

Bank References

1.

Name
Street Address
City
State
Zip Code
Home Phone Number

2.

Name
Street Address
City
State
Zip Code
Home Phone Number

3.

Name
Street Address
City
State
Zip Code
Home Phone Number
Signature
The undersigned certifies that the information supplied in the questionnaire is true and correct.
Signature
Date

You may print and return the personal and financial questionnaire to:


Fax: 770-772-6096

You may also submit this questionnaire electronically by clicking on the "Submit Questionnaire" button below.

 

 
 
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