First Name *

Last Name *

Street address *

What region do you live in? * North Auckland South Auckland Bay of Plenty Canterbury Gisborne Hawkes Bay Manawatu-Whanganui Marlborough Nelson Northland Otago Southland Taranaki Tasman Waikato Wellington West Coast Auckland City West Auckland East Auckland Hamilton Auckland Wairarapa

Mobile phone number *

Email *

What is your nationality? * Maori Tokelauan Fijian Niuean Tongan Cook Islands Maori Samoan Other Pacific Peoples Southeast Asian Indian Chinese Other Asian Middle Eastern Latin America African Other European NZ European/Pakeha

How long have you lived in New Zealand? * 0 - 2 years 2 - 5 years 5 years or more

What is your residency status? * Citizen Permanent Resident Resident Work Visa

Have you ever owned a business? * Yes No

Have you ever had a registered company in New Zealand? * Yes No

Have you ever been declared bankrupt? * No Yes

Have you ever been convicted of a criminal offence in New Zealand or overseas? * No Yes Please note: Becoming a Jani-King franchisee business owner requires a no convictions Ministry of Justice New Zealand check. Please be aware that Jani-King reserves the right to decline the sale of a franchise based on the results of this check.

How will you finance your franchise? * Self-funded I have a pre-approved loan I will need assistance with finance Unsure Please note: Investing in a cleaning business may not generate immediate income during the first 3 to 4 months. It’s essential to ensure you have sufficient funds available to support yourself until the business starts to provide returns.

Do you hold a full valid New Zealand driver’s license? * Yes No Please note: Since you’ll be representing Jani-King, it’s important that the vehicle you use is registered in New Zealand, has a current Warrant of Fitness (WOF), covered by insurance, clean, tidy, and well-maintained.

How much money are you planning to earn with your Jani-King cleaning business? * $0 - $3000 $3,000 - $5,000 $5,000 - $8000 $8,000 - $10,000 Over $10,000

What purpose does this business serve for you? * Run a full-time businessOperate part time for extra incomeEmploying staffBuild a long-term, growing business

Do you have any experience or accreditation in any of the following? * Commercial cleaningBusiness ownershipWorking at heights accreditationTest and tag licenseCarpet cleaningHard floor careBuilding washesHeat pump servicingFirst aid certificateFacilities management experience

How would you rate your English language skills? * I am a native English speaker I can communicate easily in English, both in writing and speaking can communicate in English but sometimes need support with complex writing or conversations I am still learning English and may need help with communication Please note: Strong English communication skills are essential for your business success and meeting health and safety requirements. You’ll need to understand client expectations, respond professionally to emails, and engage in face-to-face conversations with your clients as part of your daily business activities.

Do you have any physical or health considerations that you think might affect your ability to participate in physical activities related to commercial cleaning? * No, I have no physical or health considerations that would affect my ability to perform physical activities related to commercial cleaning Yes, I have some considerations that might affect my ability to perform certain tasks. I prefer not to disclose.

Details of Physical / Health Considerations: *

How did you hear about Jani-King? Friend Current Jani-King Franchise business owner TradeMe Google Search Franchise NZ Magazine or website Social Media (Facebook, Instagram, TikTok) I have previously applied Other

DISCLOSURE AGREEMENT * I acknowledge and agree with the Disclosure Statement By completing this application, I confirm that I am over 18 years old, and all the information provided is true and accurate to the best of my knowledge. I understand that this application is part of the process to assess my suitability for purchasing a Jani-King franchise.

AGREEMENT NOT TO DISCLOSE * I acknowledge the Non Disclosure Statement and I will keep the information confidential I acknowledge that the Information I have received or am about to receive concerning Jani-King’s system and concept may include trade secrets and intellectual property which solely belong to Jani-King International and Jani-King (NZ) Limited. I agree not to disclose any of this information to others to be used for their benefit nor will I use this knowledge for my personal benefit. I agree the information I have and will receive belongs solely to Jani-King and I will not divulge this information to others or misuse this information for my own personal benefits. I am not acting for or on behalf of anybody else and have not been engaged by anybody else directly or indirectly to obtain any information regarding Jani-King (NZ) Limited on their behalf.

CONSENT TO STORE PERSONAL DATA * I agree to allow Jani-King New Zealand to store and process my personal data In order to provide you the content requested, we need to store and process your personal data. If you consent to us storing your personal data for this purpose, please tick the checkbox below.

Jani-King Communications * I agree to receive other communications from Jani-King New Zealand. Jani-King New Zealand is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide the products and services you requested from us. From time to time, we would like to contact you about our products and services, as well as other content that may be of interest to you. If you consent to us contacting you for this purpose, please tick below to say how you would like us to contact you. You can unsubscribe from these communications at any time. For more information on how to unsubscribe, our privacy practices, and how we are committed to protecting and respecting your privacy, please review our Privacy Policy.

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