Expression of Interest to Lease Premises – Tenant Application Form

Thank you for your enquiry regarding leasing premises at Curtin University.

So that we can ensure a successful, long term relationship, we would ask that you complete the following
application and return it to our office for consideration.

Please Note: This is an application form only to lease premises. It does not signify any acceptance by the
owner, of you as a lessee.

We ask you to complete all details in full to avoid any delays in processing and responding.

1. PROPOSED LESSEE NAME (SOLE TRADER, PARTNERSHIP, COMPANY):

2. CURRENT TRADING NAME:

TELEPHONE: EMAIL ADDRESS:

3. TYPE OF BUSINESS AND CORE PRODUCTS BEING OFFERED :

4. PLEASE LIST ALL RETAIL EXPERIENCE TO DATE:

5. WHAT RETAIL OPERATIONS DO YOU CURRENTLY HAVE AND WILL THEY CONTINUE TO OPERATE IN THE
EVENT YOU OPEN A RETAIL SITE ON CAMPUS:
6. WHAT “POINT OF DIFFERENCE” DOES YOUR BUSINESS OFFER OVER SIMILAR BUSINESSES ALREADY
OPERATING ON CAMPUS:

7. HOW MUCH SPACE AND IDEAL LOCATION (IF KNOWN) IS REQUIRED TO OPERATE ON CAMPUS:

8. DESCRIBE ANY SPECIAL OPERATIONAL NEEDS IN ORDER TO TRADE :

9. BANKERS DETAILS:

10. PLEASE ATTACH THE MOST RECENTLY AUDITED FINANCIAL REPORTS FOR YOUR BUSINESS:

11. HAVE YOU APPLIED OR RECEIVED FINANCE TO FUND ANY “FIT OUT” EXPENSES:

12. BUSINESS EXPERIENCE REFERENCES (AT LEAST TWO):

A. CONTACT NAME:
ADDRESS:
BUSINESS / COMPANY DETAILS:
CONTACT DETAILS:

B. CONTACT NAME:
ADDRESS:
BUSINESS / COMPANY DETAILS:
CONTACT DETAILS:

C. CONTACT NAME:
ADDRESS:
BUSINESS / COMPANY DETAILS:
CONTACT DETAILS:
 YOUR INDEPENDENT ESTIMATED TURNOVER FOR YOUR FIRST 12 MONTHS:
$________________________

Estimated average sale per customer: $________________________

WILL YOU BE MANAGING THE BUSINESS ON SITE YOURSELF OR APPOINTING A STORE

MANAGER? (PLEASE TICK APPROPRIATE BOX)

 Managing Self
 Appointing Manager

WHAT WOULD YOU ANTICIPATE THE STORE’S STAFFING REQUIREMENTS TO BE:

Number of full time______________ Part-time_______________ Casual__________________
Percentage of wages to sale________________%

STATEMENT

We acknowledge that this preliminary application does not signify any contractual obligation on
either party in respect of leasing premises at Curtin University.
We further understand that additional information may be required.

I/We declare that I/We, the Lessee(s) or proposed Lessee Company Directors, are not undischarged
bankrupts, nor that any judgement has been recorded against the proposed Lessee Company or any
of its Directors or any Estate or asset has been assigned for the benefit of creditors.

Signed: _________________________________________

Date: ______/________/___________