Please complete all fields unless otherwise declared.
Location Applying for
Antigua and Barbuda
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Cocos (Keeling) Islands
Congo, The Democratic Republic of The
Falkland Islands (Malvinas)
French Southern Territories
Heard Island and Mcdonald Islands
Holy See (Vatican City State)
Iran, Islamic Republic of
Isle of Man
Korea, Democratic People's Republic of
Korea, Republic of
Lao People's Democratic Republic
Libyan Arab Jamahiriya
Macedonia, The Former Yugoslav Republic of
Micronesia, Federated States of
Moldova, Republic of
Northern Mariana Islands
Palestinian Territory, Occupied
Papua New Guinea
Saint Kitts and Nevis
Saint Pierre and Miquelon
Saint Vincent and The Grenadines
Sao Tome and Principe
South Georgia and The South Sandwich Islands
Svalbard and Jan Mayen
Syrian Arab Republic
Tanzania, United Republic of
Trinidad and Tobago
Turks and Caicos Islands
United Arab Emirates
United States Minor Outlying Islands
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Please enter all relevant information for yourself and/or the organization for which you are applying and include GNC or other wellness industry experience. Provide a basic description of your organization as a whole and the size:
What are you looking for in a relationship with GNC?
What is the estimated initial investment to support your business interests and the source(s) of the investment?
Why do you believe your Company is the most qualified to represent the GNC product line in your country?
What do you feel are the key business opportunities for the GNC brand in developing a business in country? How can they be executed and what are the requirements to do so?
What are the regulatory requirements to register proteins, supplements, and other types of consumer health products in your market(s)?
I hereby authorize GNC Holdings, LLC to investigate my background and qualifications for purposes of evaluating my qualifications to be a GNC Franchise Operator. I understand that such investigation may include an investigative consumer report, as well as a general background search and an investigation in accordance with anti-terrorism legislation, such as the USA Patriot Act and Executive Order 13224 enacted by the U.S. Government. I understand that these investigations may reveal information as to my creditworthiness, credit standing, credit capacity, character, general reputation, personal characteristics and mode of living. Accordingly, I voluntarily and knowingly authorize any present or past employer or supervisor, law enforcement agency, state or federal agency, credit bureau, collection agency, banking institution, private business, military branch or the National Personnel Records Center, and/or other persons to give records or information they may have concerning my loan balances, criminal history, and employment records or any other information requested, to GNC Holdings, LLC and/or its parent companies, subsidiaries or agents. I voluntarily and knowingly and unconditionally release any of the above-named agencies and/or individuals from any and all liability resulting from furnishing this information.
I understand that upon written request, GNC will make available to me a complete and accurate disclosure of the nature and scope of the investigation requested, as well as a copy of a summary of my rights as a consumer under the Fair Credit Reporting Act.
The information contained in this application is provided for the purpose of obtaining a franchise and/or maintaining credit with franchisor on behalf of the undersigned.
I understand that, if I am approved to become a GNC Franchise Operator, GNC may rely on this authorization and have additional background checks conducted during and throughout the term of my Franchise Agreement without asking for my authorization again.
The undersigned expressly agree(s) to notify franchisor immediately in writing of any material change in his/her/their financial condition.
The undersigned certifies that each part of the application and financial statements hereof and the information inserted herein has been carefully read and is true and correct. The undersigned further acknowledges and agrees that the granting of a franchise is at the sole discretion of GNC Holdings, LLC and that the filing of this application does not obligate the applicant to purchase or GNC to sell a franchise or location.
According to the Fair Credit Reporting Act, I am entitled to know if credit is denied because of information obtained from a consumer reporting agency. I will be so advised and given the name of the agency or source of information.
A photocopy of this release will be valid as an original even though the said photocopy does not contain an original written signature.