Application No.

______ - ___________

DEALERSHIP APPLICATION FORM

Name of Applicant

Date of Application

Applying for Area/Site

By filling up and submitting this application form, the applicant confirms that he/she shall abide by Unioil Petroleum Philippines
Inc. dealership application process.

Page No. 1
 Application No. ______ - ___________

PERSONAL INFORMATION
Full Name (Surname/First Name/Middle Name)

Home Address (House no., Street, Village, Barangay, City/Province)

Please attached your most
Mobile/Home Tel. No. Email Address Marital Status recent 2 x 2 photo

Date of Birth Place of Birth Nationality

Name of Spouse (Surname/First Name/Middle Name) Date of Birth

Dependent Information

Name Age Profession (if working already)

Physical disability or limitation Major illness for the past years

EDUCATIONAL BACKGROUND
Name of School/College Inclusive Years Degree Completed

High School

College

Post-Graduate

Trainings and Seminars Attended (Sales, Business Management, Retailing, etc.)

Training/Seminar Training Date Training Conducted By

EMPLOYMENT BACKGROUND (if currently or previously employed)

Present Occupation Position Date Employed

Company Name Address Contact No.

How much time do you usually spent in your work? What is/are your daily routine in your work?

Please elaborate your current duties and responsibilities. Identify major milestone/success in your work.

Major challenge encountered and how did you resolved it.

PLEASE FILL UP ALL ITEMS. INCOMPLETE APPLICATION FORMS WILL NOT BE PROCESSED Page No. 2
 Application No. ______ - ___________

Employment History

From To Company/Employer Address Ave. Monthly Income

Position with longest service Company No. of years

BUSINESS EXPERIENCE
Present Main Business Nature of Business Years in Business
Business Address (in full) Contact No. Email Address

Type of Ownership No. of Branches (if any) Annual Sales Annual Income

List down your other business experience.

Name of Business Nature of Business Operating Year Ave. No. of Ave. Tenure of If Business is close,
From To Employee(s) Employee(s) please provide reason

How much time do you spend in your current business?

What is/are your daily routine in your current business?

In your current business, what are the duties/responsibilities/problems that you personally handle?

Have you encountered any labor issue/case? How did you resolve it?

Identify major milestones/success in your business for the past 5 years.

What do you think are the reasons behind your business success?

FINANCIAL BACKGROUND
This portion of the application form aims to determine your capacity to fund the capitalization requirement to open a Unioil Gas Station
and sustain its future operation.
Sources of Income Please declare name of Employer, Sub-Business and other sources including annual income.

Employment
Businesses
Others (e.g. income of spouse)

PLEASE FILL UP ALL ITEMS. INCOMPLETE APPLICATION FORMS WILL NOT BE PROCESSED Page No. 3
 Application No. ______ - ___________

HOME INFORMATION

Owned Living with Parents Rented

If owned, Fully Paid Partially Paid Living with Relatives Others

REAL ESTATE PROPERTIES OWNED

Type of Property Location Lot Area Market Value Mortgagee

(if applicable)

VEHICLES OWNED

Make Type Model Plate No. Place of Registration Mortgagee

(if applicable)

CREDIT AND BANK REFERENCE (under the name of the applicant and spouse)

Name of Bank Length of Dealings Type of Transaction Ave. Daily Balance Credit Extensions

Note: Bank Certificates to be submitted as a proof upon request.

How much are you willing to invest in this business? Is it available anytime?

Coming from what source? Please specify.

BUSINESS PLANS
What are your key motivator(s) for investing in a Unioil Gas Station?

Why are you the best candidate to manage the Gas Station in your desired area/territory?

If the dealership will be granted to you, what will be your main participation in the operation of the station?

If you are currently employed, how will you manage the Unioil Gas Station Business?

How much time will you be able to spend in managing the Unioil Gas Station Business?

Why did you decide to apply for this area/territory?

PLEASE FILL UP ALL ITEMS. INCOMPLETE APPLICATION FORMS WILL NOT BE PROCESSED Page No. 4
 Application No. ______ - ___________

Are there other territories that you are interested in?

How much do you expect to be your monthly earnings from this Unioil Gas Station Business?

Are you willing to undergo two (2) weeks full-time classroom and hands-on training of Unioil?

Do you currently operate other Gas Station Dealership or other franchise business? If yes, please provide details.

Do you have pending dealership application with other Petroleum Companies?

Do you have relative(s) up to 3rd degree of consanguinity or affinity that operates other Gas Station brand?

SOCIO-CIVIC AFFILIATIONS (e.g. Rotary, Lions, Mason, etc.)

Name of Affiliation Chapter Position Member Since Member Status

What were your personal contribution(s) to the organization for the past two (2) years?

Please indicate personal/business gains you got from joining the organization (if any).

PERSONAL REFERENCES
Name Relationship Business/Occupation Contact Number(s)

NOTICE OF DISCLOSURE
I hereby affirm that the information/data I have provided to Unioil Petroleum Philippines Inc. in this six (6) page application form
disclosing my character, general reputation, personal characteristics and financial background is voluntary and is for the purpose of
dealership application assessment.

I also hereby confirm that all information/data that I have provided are true and correct.

In addition, by signing below, I release any and all former and/or present employers and any other personal or business references from
any liability whatsoever in connection with Unioil Petroleum Philippines Inc. attempts to investigate my background and determine my
fitness to become a Unioil Dealer.

I understand that this application is considered as active for Three (3) years from the date below. I understand that Unioil Petroleum
Philippines has the right to reject my application without assigning any reasons whatsoever.

Finally, I do understand that any changes in the information/data that I have provided in this application form will invalidate my
application for Unioil Dealership.

Application Date Page No. 5

Applicant’s signature over Printed Name