National Operator Program

Company Name

EIN Number

Years In Business

Address

City

State

Zip Code

Phone

Website

Email

Fax

Owner Name & (S)/Title

Principles with 10% interest or more

Are Your Currently Expanding?
YesNo

Number Of Employees

Are You an AMOA Member?
YesNo

Other Equipment?

Cranes?
YesNo

Vending Machines?
YesNo

Arcade Equipment?
YesNo

If Yes, What Kind?

Music?
YesNo

Other Photo Booths / Besides Apple Product?
YesNo

Types of Photo Booths currently in use

Current Location Types:

Bowling?
YesNo

Pizza?
YesNo

Movie?
YesNo

Retail Store?
YesNo

Fast Food?
YesNo

Bar?
YesNo

Other:

Describe Your Current Territory:

Business Reference #1:

Reference #1 Phone:

Business Reference #2:

Reference #2 Phone:

Business Reference #3:

Reference #3 Phone:

This Operator Application does not constitute a contract to participate in Apple Industries’ National Operator Program and does not create any legal obligations between you and Apple. It is intended that all legal rights and obligations between the Applicant and Apple Industries will come into existence only when a definitive contract is both signed and delivered by both Apple and the Operator. The legal rights and obligations of Apple Industries and the Applicant shall then be only those which are set forth in the contract.