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- STRICTLY CONFIDENTIAL -

PROPERTY PROFILERS APPLICATION FORM

Thank you for your interest in acquiring a Property Profilers Licence.

This attached application is provided to you, “the Applicant”, by Property Profilers Limited. This application does not obligate either party in any manner and does not represent an offer to sell a Licence.

As the information provided will be relied upon by, and form the basis for a number of decisions by Property Profilers Limited, it is a fundamental requirement that all information be true, accurate and in no way misleading.

Once your application and supporting information has been received by Property Profilers Limited we will contact you to arrange a personal interview.

The purpose of this interview is to review the information you have provided and discuss more fully your future business plans with us. It will also give you an opportunity to ask any further questions you may have of Property Profilers Limited.

Prior to the commencement of the personal interview you will be requested to sign a Disclosure Document.

Tell Us About Yourself -----
Please be specific in completing all of the questions, this will assist us when reviewing your application.

*required fields

PERSONAL INFO

First Name: *

Middle Name:

Last Name:*

Are you or have you been known by any
other name(s):

yes no

If yes, please state name(s):

Current address:

How long have you lived at this address?:

Telephone Number:*

Mobile Number:

Email address:*

Date of birth:


(e.g 24/09/1982)

Previous Address:

   

Do you own a home?

yes no

Are you legally able to work in New Zealand?

yes no

Do you have any qualifications which may be relavent to this application?

yes no

Do you hold a current NZ Drivers Licence?

yes no

Date Obtained:


(e.g 24/09/1982)

Details of the vehicle you intend to use in the course of your Property Profilers business activities:

Make & Model of car:

Year of Manufacture:

General Condition:

Excellent:

Average:

Fair:

Have you ever been convicted of a Criminal Offence including Traffic and Driving Offences?
(If "Yes" please provide details)

yes no

Have you or any business in which you have held an interest ever filed under bankruptcy
or receivership?

yes no

Why do you want to buy a Property Profilers Licence, and in particular what features of this business have attracted you?

yes no

•

Are you comfortable about the idea of working in co-operation with Property Profilers Limited?

yes no

 

•

Do you accept that a number of disciplines exist in a Licence system, in particular working under the direction and guidance of the Licensor?

yes no

 

•

Are you aware certain information provided and/or advised to you is confidential and shall not be divulged to any third person unless Property Profilers Limited gives its prior approval?

yes no

 

•

Do you understand that you must make your own enquiries and get your own professional advice when considering this business opportunity?

yes no

 

How did you hear about Property Profilers?

What are your interests/memberships?

Have you ever owned or worked within a real estate related business? (If "Yes" give particulars)

yes no

 

  

COMPUTER KNOWLEDGE

Please indicate your skill level for the following:

General use of the internet:

  

Non-existent

Beginner

Medium

High

 

Search Engines:

  

Non-existent

Beginner

Medium

High

Email:

  

Non-existent

Beginner

Medium

High

 

Word Processing: (Which programme/s):
 

Non-existent

Beginner

Medium

High

Spreadsheet & Database: (Which programme/s):
 

Non-existent

Beginner

Medium

High

PowerPoint or similar: (which programme/s):

 

Non-existent

Beginner

Medium

High

Contact Management: (which programme/s):
 

Non-existent

Beginner

Medium

High

Accounting: (which programme/s):
 

Non-existent

Beginner

Medium

High

 

DECLARATION


I (name) of (address) declare as follows:

I have answered the questions and provided the information in this form to the best of my knowledge and belief, and that the answers and information are true and correct in all respects and that no relevant details have been omitted.

I acknowledge that if any information included in this Application is false or misleading in any way, Property Profilers Limited shall have the right to terminate any Licence agreement entered into on the basis of the information contained in this Application.

I also acknowledge and agree that Property Profilers Limited:
(please tick)

1.

is collecting the information contained in this Application to assess whether I should be considered as a potential Licensee;

2.

is relying upon the information contained in this Application as a material factor in considering this Application;

3.

is authorised to contact any appropriate third parties to verify the accuracy of the information in this Application and to retain any information obtained for its records;

4.

may provide the information contained in this Application to its advisers, including its accountants, lawyers and consultants.

If I do not become a Property Profilers Licensee this information is to be destroyed or returned to me at my request.
Name:
Area:
Email address:
Would you like more info on property profilers in your area?
Contact phone number:
0800 362 039 | www.profilers.co.nz | info@profilers.co.nz