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Franchise Opportunities: Register and Apply

Register and Apply

Please complete all sections carefully and thoroughly. You may submit your current CV as additional material.

The information submitted on this form will be treated by Pirtek as strictly private and confidential and will only be used for the purposes of evaluating your application for a Pirtek franchise.

Personal Details

Equal Opportunities

Pirtek is committed to equality of opportunity and to monitoring its Diversity Policy in respect of franchise applicants in accordance with the Code of Practice issued by the Commission for Racial Equality, the Equal Opportunities Commission and the Code of Practice relating to the Disability Discrimination Act.

Please answer the following question which will be used for monitoring purposes only.

Pirtek seeks to offer franchising opportunities irrespective of mental or physical disabilities wherever possible and will make any reasonable adjustments to ensure that people with disability can compete equally with non-disabled people.

Education History

Career History

Please start with your most recent employment.

Employer/Business Name Date From Date To Position Duties and responsibilities
and number of employees
Salary on leaving Reason for leaving

Personal Financial Statement

Income for the last 12 months




     If yes, please explain:

     If yes, please explain:

     If yes, please explain:

Financial References

Please give significant references. Give details of banks, building societies, commercial companies with whom you have conducted business.

Name Address Telephone Contact

About your application

Personal References

Please give names of individuals (not relatives, preferably business people) who can attest to your ability, personal character etc. and whom you give permission for Pirtek to contact. No contact will be made until you have been accepted onto the Franchise Training Programme.

Name Address Telephone Email Type

MS Word or PDF format only

I certify that the facts contained in this Application are true to the best of my knowledge and beliefs. I will inform Pirtek in writing of any material changes to them. I authorise Pirtek to carry out such checks and investigations relating to me as deemed appropriate. I understand that misrepresentation or omission of factual information requested may be a cause for removal from the Pirtek System. The information supplied in this form may be used by Pirtek to evaluate my suitability to become a Pirtek Franchisee or for research or statistical purposes that are complementary or ancillary thereto.

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Next Steps...

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