In order to be considered for a CSG Regional License for your country, please complete and submit the form below. This form does not obligate either party in any manner!
Name of Company or Individual Principal Owner......... President/Managing Dir. Street City......................... State/Province Postal Code.... Country Phone Number............ Fax Number E-Mail Company Structure (i.e. Limited, Public, Private) Type of Business.... Number of Years in Business Number of Shareholders.. Annual Sales Last Year Capital Available....... Number of Employees Bank Reference Bank Name............ Years in Business Together Street City......................... State/Province Postal Code.... Country Contact Person............... Title Phone Number............ Fax Number Two Trade References
Reference 1: Name of Company...... Years in Business Together Street City......................... State/Province Postal Code.... Country Contact Person............... Title Phone Number............ Fax Number Reference 2: Name of Company...... Years in Business Together Street City......................... State/Province Postal Code.... Country Contact Person............... Title Phone Number............ Fax Number Are you currently doing business with an American company? Yes No
If Yes: Name of Company...... Years in Business Together Street City......................... State/Province Postal Code.... Country Contact Person............... Title Phone Number............ Fax Number Please state the purpose for seeking our Master License, and the time frame you'd be ready to start, if awarded Please state two (2) reasons why you could make our franchise a success in your country By submitting this form, "I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. SUBMITTING THIS FORM DOES NOT OBLIGATE EITHER PARTY IN ANY MANNER."