Franchise Support Service/Supplier Membership Application

Section 1: Applicant Information

Full Legal Company Name:(Required)

Trade / Brand Name:(Required)

Head Office Street Address:(Required)

Address Line 2

City(Required)

Province / Territory(Required)

Postal Code / ZIP(Required)

Country(Required)

Website:(Required)

Website for Franchising Information:

Has the applicant previously held CFA membership?(Required)

Yes

No

if "yes", when?

Official Designee to CFA

The Official Designee is the primary contact for membership renewals, member surveys, invitations to program or major membership matters. This contact would also be entitled to take advantage of (or assign) the complimentary convention delegate registration we provide to new approved members in their first year.

First Name:(Required)

Last Name:(Required)

Title:(Required)

Office Address:

Phone(Required)

Cell

Section 2: Business History

Year when applicant began operation(Required)

Year when applicant began providing products/services to the franchise industry(Required)

Section 3: Industry Type

Please select ONE of the following categories that best describes your business(Required)

Section 4: Legal Matters

Is the applicant registered or licensed in any jurisdiction by a competent licensing body to deal with the public in any capacity?(Required)

Yes

No

If “YES”, please specify the body and jurisdiction below:

Has the applicant been refused registration or any license, or has any registration or license been suspended or cancelled, or is the applicant operating without any necessary registration or license, in any jurisdiction?(Required)

Yes

No

Been adjudged or voluntarily become bankrupt; reorganized due to insolvency; taken the benefit of any statute for the relief of bankrupt or insolvent debtors; or, become subject to any pending bankruptcy, insolvency or reorganization proceeding?(Required)

Yes

No

Had any conviction(s) for an indictable offence under the Criminal Code of Canada, within the last seven (7) years, which remains outstanding?(Required)

Yes

No

*If you answered “Yes” to any of the questions in Section 3, please provide details below

Section 5: Membership Dues and Payment Information

*Indicate your dues category based on the total gross sales for your most recent fiscal year or calendar year (defined as the total system wide sales in Canada, including franchisee and corporate units, and not just royalty revenues of the Franchisor).*

STEP 1: Select Your Dues Category:(Required)

Dues

How do you intend to pay for your CFA Membership?(Required)

Electronic Funds Transfer (EFT)

Credit Card

Other

Section 6: How did you Learn About the CFA?

Referred by (Name/Company):

Advertisement/Article/Mailing/other (please specify):

What benefits are most important to you in joining CFA?

Section 7: Authorization, Declaration and Acknowledgement

By completing the boxes below and submitting the application, I authorize the following:

1. I represent and warrant to the CFA that I have authority to act on behalf of the applicant.
2. I certify that the applicant has the exclusive rights to grant franchises in all of Canada.
3. I declare that the information given on or pursuant to this application is true and complete and not misleading in any way.
4. On behalf of the applicant, I authorize the CFA to make enquiry of such persons and organizations, including the applicant’s franchisees and any other parties with which the applicant has business or financial relations, and any credit reporting agency, bank, or credit grantor, as the CFA considers reasonably necessary to obtain credit and other information regarding the applicant and the applicant’s principals.
5. I confirm, on behalf of the applicant, that the applicant has read and understood, and endorses and subscribes to the CFA Code of Ethics, including CFA disclosure requirements. I acknowledge, on behalf of the applicant, that any failure of a CFA member to comply with the Code of Ethics may result in suspension of membership privileges or in termination of membership without refund of dues paid.
6. Membership dues are non-refundable following approval of membership.

Company Name:(Required)

Title:(Required)

Authorized Signing Officer:(Required)

Date(Required)

Signed CFA Code of Ethics(Required)

I confirm that I have read, understood, endorse and subscribe to the CFA's Code of Ethics.