Application Form
BP FRANCHISE/DEALERSHIP
PERSONAL DETAILS OF APPLICANT
First Name Surname
Physical Addresse (Residential)
Code
What is the proximity of your residential km
address to the Site that you are applying
for?
Postal Address:
Code
Tel Nr (Home)
Tel Nr (Work)
Cellular Nr
Email address:
Identity Nr
Date of Birth:
Nationality:
Are you prepared to accept long and YES NO
irregular working hours?
Do you have the support of your YES NO
immediate family?
EDUCATION AND QUALIFICATIONS
Name of Secondary School
Date Attended
University/College
Date Attended
Diploma/Degree
OTHER ACADEMIC QUALIFICATIONS
Name of Institution
Course Name:
Outcome (Pass/Fail)
Professional Qualification
EMPLOYMENT/WORK HISTORY
Current Employer Name:
(if self-employed, please describe in detail)
Address
Position/Title
Date Commenced:
Main Responsibilities:
Current Salary (per annum)
Bonus:
Pension:
Annual days leave
Other company benefits
Previous Employer Name:
(Cover only the last 15 years)
Address
Position/Title
Date Commenced:
Main Responsibilities:
Previous Employer Name:
(Cover only the last 15 years)
Address
Position/Title
Date Commenced:
Main Responsibilities:
Previous Employer Name:
(Cover only the last 15 years)
Address
Position/Title
Date Commenced:
Main Responsibilities:
Have you ever owned or worked in a business similar to the proposed franchises apart
from any information given above? YES NO
If YES, please give details. Detail any other relevant experience.
Have you ever had experience in the following areas?
Handling Cash
Staff Management & Recruitment
Analyzing Cash Flows
Stock Control
Retail/Selling to the public
Working with Financial Statements
Working weekends
FINANCIAL INFORMATION
How much of your own capital do you intend to invest?
How much will be borrowed capital?
How many hours per week are you willing to spend at thee service station?
Are you pursuing other business opportunities as well YES NO
If YES above, in which industry are you pursuing other opportunities?
If your application for the BP Franchise or Dealership is not successful, what are your future plans?
Have you, or your spouse, or any business entity in which you jointly or separately owned interest, been
involved in bankruptcy, insolvency proceedings or any compromised offers with creditors? YES NO
If YES, give full details:
Have you or your spouse ever had a judgement in respect of a debt recorded against you? YES NO
If YES, give full details
FINANCIAL INFORMATION
BANKING DETAILS (Business)
Banking Institution
Account Holder
Account number
Branch Code
Type (Savings/Current etc)
BANKING DETAILS (Personal)
Banking Institution
Account Holder
Account number
Branch Code
Type (Savings/Current etc)
If your present funds are less than required to purchase a service station, how do you propose to finance the
venture?
Present Income (Annually) Present Expenditure (Annually
Wage/Salary after R Monthly Mortage/Rent R
Tax repayments
Bonus/Commission R Monthly Loan repayments R
Dividends R
Property income R
Other income R Other (Details) R
(Details) R
.
TOTAL R R
FINANCIAL INFORMATION
Assets Liabilities
(Cash in Banks/Building Society)
Bank: R Current Overdraft: R
Branch:
Type Account:
Bank: R Current Overdraft: R
Branch:
Type Account:
Investments (net realizable value Hire Purchase R
of shares, bonds, unit trusts, repayment
insurance etc).
List:
R Monthly Personal R
Loan Repayments
R Other Loan R
Repayments
Other Assets Other Liabilities
Monies due to you: R Loan guaranteed
(Details). for others (Details)
R
R
R
Property (Market value) R Mortgage Payable R
Market Value of Business R Any other debts:
(If applicable) (Details)
R
Any other assets
(Details):
R
MANAGEMENT STRUCTURE
Would the business be managed as a Closed Corporation, Private/Public company, Partnership or by
yourself as Sole Proprietor? Complete relevant section in detail:
Closed Corporation
Name and registration number of Closed Corporation:
Please list full names, surnames and ID nr’s of all members:
FULL NAME: Shareholding proportion: %
SURNAME
ID NR:
FULL NAME: Shareholding proportion: %
SURNAME:
ID NR:
FULL NAME: Shareholding proportion: %
SURNAME:
ID NR:
Partnership
Name and registration number of Closed Corporation:
Please list full names, surnames and ID nr’s of all members:
FULL NAME:
proportion: %
ID NR:
FULL NAME:
proportion: %
ID NR:
FULL NAME:
proportion: %
SURNAME:
proportion %
ID NR:
Sole Proprietor
Trading Name of Sole Proprietor:
REFERENCES
Business/Work
(If self-employed -customer/client)
Name:
Job Title:
Company Name:
Contact Numbers:
Financial
(If self-employed -customer/client)
Name:
Job Title:
Company Name:
Contact Numbers:
I am applying for the following opportunity:
Signature:
I understand that the purpose of this application is for information only. It is no way binding upon BO
(the Franchisor), or me (potential Franchisee). I understand and grant BP permission to contact me
referees, previous employers and agencies to verify my credit and criminal records. I certify that all
the information given above is correc.t
Full Names and Surname of Applicant:
Signature of Applicant:
Date:
Please note that if you are interested, please provide proof of funding” with your
application.
Only shortlisted candidates will be contacted. Should you not hear from us within 14 days after
closure of the receipt of applications.
In addition, the following documentation needs to be submitted to Supportretail1@bp.com
o Application form
o Certified ID Copy
o Company documents
o Shareholding Certificate
o Proof of residence
