For additional information regarding this application, please call extension 14 or send an to

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Incredible Pizza Franchise Group, LLC (IPFG)

REQUEST FOR CONSIDERATION

TO BECOME A FRANCHISEE

Thank you for your interest in Incredible Pizza Company. Please complete the following application

 Application Process

As a prospective franchisee, please complete this franchise application and then we will set an appointment to

interview with our Franchise Representatives at Incredible Pizza Company in Springfield, Missouri.

 Application submitted by prospective franchisee

All candidates and partners will submit a completed application to be considered.

 Financial Approval

IPFG evaluates each application to ascertain a candidate’s financial ability to successfully capitalize an

Incredible Pizza Family Entertainment Center (“IPFEC”). We will accept a pre-printed personal

financial statement if you have a current one prepared. Please note (ALL APPLICANTS MUST FILL

OUT OR PROVIDE THE FINANCIAL STATEMENT BEFORE BEING CONSIDERED)!

 Introductory Call

Once approved, candidates will then receive an introductory call from Incredible Pizza Company

detailing the basic information about franchising opportunities. In addition, you will receive a copy of

the Incredible Pizza Franchise Group Franchise Disclosure Document (“FDD”).

 Detailed Call

After a few days you will receive a call where all other questions may be addressed. When your

questions have been answered, we will make arrangements with you to schedule a one-day trip to

Incredible Pizza Company in Springfield, Missouri to begin to gain an understanding what is involved in

owning an Incredible Pizza Family Entertainment Center Franchise. Candidates meet with

representatives of the Franchise Operations to discuss facility management, construction management,

personnel, training requirements, development goals and objectives.

 Development Process

 Franchise Agreement Signed and Franchise Fee Paid

 Site Development Form Completed

IPFG will make arrangements to visit your site and decide if it is acceptable for an IPFEC

 Site Approved and Financing Secured

If your site is approved, the next step is to sign a Management Agreement, Project Consulting

Agreement and pay the appropriate fees listed in the FDD that pertains to these two agreements.

 Construction Begins

 Family Entertainment Center Approved to Open

 Pre-opening parties

 Opening Day

For additional information regarding this application, please call 417.890-1408 extension

14 or send an email to [email protected].

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A

PPLICATION

F

OR AN

I

NCREDIBLE

P

IZZA

F

AMILY

E

NTERTAINMENT

C

ENTER

F

RANCHISE

Personal Data

Full Name

(Last) (Middle) (First)

Social Security No.

Primary Residence Address

City State Zip

Telephone no.: Residence ( ) Daytime (if different) ( )

If, the daytime phone no. is your work no., may we contact you at work? Y / N Fax #: (_______________________________)

Driver’s License No.: State:

Date of birth Country of Citizenship

Marital status

Name of Spouse

(Last) (Middle) (First)

Social Security No.

Occupation of Spouse Length of employment Income

Home: Own Rent Name & Phone no. of Landlord

Length of occupancy

Last former residence

(if less five years at current address)

Own Rent Length of occupancy

Education: Degree or Last year of school completed Name of college

____________________________________________________________

Employment Background

List employment history for the past ten years, beginning with the most current:

(PLEASE ATTACH PERSONAL RESUME)

Dates Company Name & Address Title Annual Income

to to to to to

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Company Data

Company Name

Federal ID No.

(As shown on tax return fillings)

Primary Address

City State Zip

Telephone no.: ( ) Fax #: (______________________________)

Date of Incorporation State

Incorporated In

Name of Officer (1)

(Last) (First) (Middle)

Title: Social Security No.

Name of Officer (2)

(Last) (First) (Middle)

Title: Social Security No.

Please indicate the primary business of your company:

Other Background Information

Have you and/or any applicable partners, officers, directors, or shareholders within your business or personal affiliations ever:

a) had any administrative, criminal, or civil action alleging a violation of any franchise law, fraud, embezzlement, fraudulent conversion, restraint of trade, unfair or deceptive practices, misappropriation of property, or comparable allegations?

Y / N

b) been convicted of a felony or pleaded nolo contendere to a felony charge or been held liable in a civil action by final judgment or been the subject of a material complaint or other legal proceeding if such felony, civil action, complaint, fraud, embezzlement, fraudulent conversion, restraint of trade, unfair or deceptive practices, misappropriation of property, or comparable allegations?

Y / N

c) been adjudged bankrupt or reorganized due to insolvency? Y / N

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Franchise Information

Location preferences: 1st

2nd

3rd 4rd

Size Concept Desired: 90,000 to 60,000 Sq Ft ____ 60,000 to 40,000 Sq, Ft. ____ 40,000 to 20,000.00 Sq. Ft ____ 20,000 to 15,000 Sq ___. Do you currently own/operate any other franchises? Y / N

If yes, please indicate franchise name(s), location(s) and type of business(es)

How will you finance this franchise investment?

Please indicate proposed management structure and names of individuals responsible for the development and finance of an Incredible Pizza Company Franchise:

All information contained herein is confidential and is strictly for the purpose of facilitating the IPFG franchise application process. All applicants will receive consideration without regard to race, color, religion, sex or national origin.

The submission of this application does not obligate either the applicant or IPFG in any manner, nor does it imply that there is any legal or commercial relationship between either party. IPFG reserves the sole right to approve or disapprove the Application for any reason it may determine, and in the event that IPFG disapproves the Application, it shall have no liability to the undersigned. It is merely a preliminary procedure.

Acknowledgment is made that the information supplied by me is true and correct. I hereby authorize Incredible Pizza

Franchise Group, LLC. to obtain any information about my credit history or other information that it deems appropriate to

evaluate my suitability as a potential Incredible Pizza Company Franchisee.

Signature Date

The application must be completed in its entirety with the following attached for franchise consideration:

a) Resume(s) which details background, work experience and other pertinent affiliations for the above mentioned individual(s).

Return Application and required attachments to:

Incredible Pizza Franchise Group, LLC

2772 South Campbell Ave

Springfield, MO 65807

Phone 417.890.1408 Ext. 14

Fax to 417.890.1635

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Corporate Name:___________________________________________________________________________________

Address:__________________________________________________________________________________________

City ___________________________ State Zip

CORPORATE, PARTNERSHIP, LP, LLP OR LLC FINANCIAL STATEMENT

If you will be purchasing an Incredible Pizza Company franchise as an individual, please complete the financial information requested below. If you will be purchasing an Incredible Pizza Company franchise as part of a Limited Partnership (LP or LLP), Limited Liability Company (LLC), Subchapter S Corporation (S Corp) or Corporation (C Corp), please provide the most recent balance sheet and income statement for your organization. In some instances both personal and corporate financial statements are required. All Franchise Agreements must be signed individually and corporately.

PERSONAL FINANCIAL STATEMENT

(A separate financial statement can be attached in place of this statement)

ASSETS

LIABILITIES AND NET WORTH

Cash on Hand and in Banks (Schedule 1)

$

Notes Payable to Banks-Unsecured (Schedule 1)

$

US Government Securities (Schedule 2)

$

Notes Payable to Banks-Secured (Schedule 1)

$

Trade Accounts and Loans Receivable (Schedule 3) $

Notes, Loans and Advances Payable to Relatives

$

Non-Trade Accounts and Loans Receivable

(Schedule 3)

$

Notes, Loans and Advances Payable to Others

$

Notes Receivable-Secured (Schedule 3)

$

Contract Accounts Unpaid

$

Notes Receivable-Unsecured (Schedule 3)

$

Interest and Rents Payable

$

Life Insurance, Cash Surrender Value (Schedule 4) $

Loans Against Life Insurance (Schedule 4)

$

Stocks and Bonds-Marketable and

Non-Marketable (Schedule 5)

$

Accounts

Payable

$

Real Estate (Schedule 6)

$

Taxes and Assessments Payable (Schedule 6)

$

Automobiles-Market Value-Registered in

Own Name Number of Vehicles

$

Mortgages Payable on Real Estate (Schedule 6)

$

Other Assets, Property or Investments (Itemize)

$

Brokers’ Margin Accounts (Schedule 5)

$

Liens on Real Estate (Schedule 6)

$

Federal and State Taxes on Current Income

$

Other Indebtedness (Itemize)

$

Total

Liabilities

$

Net

Worth

$

Total Assets

$

Total Liabilities and Net Worth

$

ANNUAL SOURCE OF INCOME

CONTINGENT LIABILITIES

Salary and/or Fees

$

Guarantor Obligations

$

Bonus and Commissions

$

Legal Claims

$

Dividends and Interest

$

Endorser or Co-Maker Obligations

$

Real Estate Income

$

Leases or Contracts

$

Business, Profession or Royalty Income

$

Liens or Special Debt

$

Other Income (Itemize)

$

Provision for Federal or Other Taxes

$

Other Liabilities (Alimony, Child Support,

Maintenance, etc.) (Itemize)

$

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Schedule 1 — Banking Relations

Name and Location

of Bank Cash Balance Outstanding Loans, Guarantees Maturity of Loan Description of Security

Schedule 2 — Government Securities

Description of Security Market Value Face Value Maturity Date Income Received Last Year Are Securities Pledged?

Schedule 3 — Accounts, Loans and Notes Receivable - Secured and Unsecured

Name of Debtor Maturity Date Face Value Monthly Installment Payments Balance Due Description of Security

Schedule 4 — Life Insurance

Insurance Company Beneficiary and Relationship Type of Policy Face Amount Present Cash Surrender Value Amount of Policy Loan Annual Premium Is Policy Assigned?

Schedule 5 — Stocks and Bonds

Name of Stock/Bond Number of Shares/Bonds Face Value of Bonds Cost Market Value Income Received Last Year Are Shares/ Bonds Pledged?

Schedule 6 — Real Estate

Address

Title in

Whose Name(s) Cost