Shell Retailer Application Form

About Shell Retail, The Proposition And The Application Form

It is important you complete this application form accurately and honestly. Incomplete and/or inaccurate information will render your application null and void. Please refer to our Privacy Statement

1 Personal Details
2 Education
3 Work/Business Experience
4 Business / Professional Reference
5 Financial Information
6 Service Station Preferences
7 Additional Information
8 Document Upload
9 Declaration by Applicant
10 Summary

For clarification or questions please contact: SCAN-BIZ-OPPS@shell.com

Step 1 of 10

★ Please review all the details that you have provided.

★

Personal Details

Salutation

First Name* Please enter your First Name as per Government issued ID

Last Name* Please enter your Last Name as per Government issued ID

Preferred Name* Enter your Preferred/ Alias Name

Birth Date * Applicant must be over the age of majority to be considered for the opportunity

Current Residential Address*

City*

Province*

Postal Code*

Current Phone Number* Please enter the 10 digit phone number

Alternative Phone Number

Email*

Do you have Permanent Residence or Citizenship Status in Canada*

I am interested in*

(Hold down the Ctrl (windows) / Command (Mac) button to select multiple options.)

I am interested in the following ventures*

Education

Highest level of education completed*

Name of institution *

Name of qualification*

Year of graduation*

Work/Business Experience

Please fill either Business Experience or Senior Business Management Experience if applicable.

What is your current employment status?*

Name of current Company* If you are unemployed currently please enter 'NA'

Position held with the company* If you are unemployed currently please enter 'NA'

Type of Business

City and Country Location of Employment Please indicate the name of the city currently worked at

Phone Number

From* Please enter starting date with format MM/YYYY. If you are unemployed currently please enter current month

To If still employed , please enter current month

Name of Previous Company*

Last position held with the company *

Type of Business

Reason for leaving *

City and Country Location of Employment Please indicate the name of the city of employment

From* Please enter starting date with format MM/YYYY

To *

Phone Number

Do you have any business lawsuits, judgements, or liens pending?*

Have you or any company with which you have been associated ever declared bankruptcy or become insolvent? *

Business / Professional Reference

Reference 1

Relationship to Reference*

Company Name*

First Name* Please enter First Name

Last Name* Please enter Last Name

Phone Number*

Reference 2

Relationship to Reference*

Company Name*

First Name* Please enter First Name

Last Name* Please enter Last Name

Phone number*

Reference 3

Relationship to Reference*

Company Name*

First Name* Please enter First Name

Last Name* Please enter Last Name

Phone Number*

May we contact your Personal/Business employment reference(s)?

Financial Information

Projected Retailer Target Earnings per annum per sites(s)* For corporate owned opportunities, Retailer on average manages 2 locations. The amount entered is the anticipated Retailer earnings per year per site.

Personal assets

Average Bank Account Balance *

Registered Retirement Savings Plan (RRSP Balance)

Unregistered Stocks and Bonds

Primary Residence Real Estate Market Value

Property Address Details

Real Estate #2 Market Value

Property #2 Address Details

Other Assets(Please specify)

Total Assets*

Personal Liabilities

Loan Details #1

Loan Details #2

Line of Credit Details

Primary Residence Mortgage Amount

Monthly Mortgage Payments

Property #2 Mortgage Amount

Property # 2 Monthly Mortgage Payments

Other Liabilities (Please specify amount details)

Please specify any other Debts/ Liabilities Outstanding

Credit Card Average balance

Total Liabilities*

Total Net Worth (Total Assets- Total Liabilities)*

Business Banking Information (If Applicable)

Business Assets

Average Business Bank Account Balance

Inventory and Asset Value

Unregistered Stocks and Bonds

Real Estate #1.

Real Estate #1 Address Details

Other Assets #1

Please describe assets #1

Other Assets #2

Please describe assets #2

Total Assets*

Business Liabilities

Business Loan

Lender

Business Line of Credit

Lender

Real Estate/Mortgage 1.

Monthly Mortgage Payments

Other liabilities #1

Please describe liabilities #1

Other liabilities #2

Please describe liabilities #2

Credit Card(s) outstanding balance

Total Liabilities*

Total Net Worth (Total Assets - Total Liabilities)*

Service Station Preferences

Same location cannot be selected . Select other location .

Shell has more than many branded sites across Canada and serves 3.8 million customers every day. Shell may contact you when opportunities in these locations becomes available.

Give your preference.

Please add your Primary Location preference for the Business Opportunity.*

Please add your Secondary Location preference for the Business Opportunity.

Please add any Other Location preference for the Business Opportunity

I am mobile and willing to relocate for a Shell Business Opportunity.

Additional Information

Have you previously applied to become a Shell Independent Retailer?

Please specify the year in which you applied

Are you applying with another person? If yes then kindly add the Application Number Kindly add your co applicants details. For example: application number(s) comma separated if there are more than one applicant or Full Name

How did you hear about the Shell Opportunity?*

Please Specify *

If successful for the Shell Self-Employer Retailer Opportunity, will you continue to be involved in other businesses or employment opportunities?

What percentage of time will you devote to the Shell Self-Employed Retailer Opportunity?

Document Upload

CV Upload *

Please upload document less than 3MB of size

You can upload only doc , docx , pdf format files.

Declaration by Applicant

Confidential Agreement potential retailer

Whereas:

Shell Canada Products ("Shell"), an Alberta partnership, intends to enter into discussions concerning Shell’s retail strategy with the Potential Retailer.

As part of such discussions, Shell may disclose Confidential Information to the Potential Retailer.

In consideration of Shell providing this information to the Potential Retailer, the Potential Retailer agrees hereby as follows:

In this Confidentiality Agreement, "Confidential Information" means all financial, technical, operational and other information, data and expertise delivered or disclosed to the Potential Retailer about Shell or Shell’s retail strategy, including but not limited to:

information respecting customers or other retailers, marketing strategies, sales volumes, operational and network information;
information pertaining to Shell owned or leased sites and operations conducted thereon;
the terms of any contract packages, contract templates, proposals, offers or confirmation letters including any financial incentives or other financial terms contemplated therein;
information pertaining to Shell’s standards and requirement with respect to the operation of a Shell-branded service station or other retail business; and
information provided during “New Retailer” training;

whether such information is provided directly or indirectly, by individuals within Shell’s organization or external consultants, and regardless of the form in which it is provided, including without limitation, in written, oral, visual or electronic form and whether disclosed prior to, on or after the date of this Confidentiality Agreement.

The Confidential Information and the terms and conditions of this Confidentiality Agreement shall be kept in strict confidence by the Potential Retailer and shall only be disclosed to such persons employed or contracted by the Potential Retailer (collectively "Representatives") in compliance with the provisions of clause 8 hereof and on a "need to know" basis for the sole purpose of evaluating whether to enter into a commercial agreement with Shell regarding the operation of a Shell-branded service station or other retail business (the "Commercial Agreement").

Except as provided in clauses 2 and 5, the Confidential Information shall not be disclosed to any third party other than a Potential Retailer's Representative by the Potential Retailer without the express written consent of Shell.

The confidentiality requirements of this Confidentiality Agreement and the term "Confidential Information" shall not apply to any information provided by Shell which:

is in the public domain at the date of disclosure to the Potential Retailer or which thereafter enters the public domain other than by any act or failure to act on the part of the Potential Retailer or one or more of its Representatives;
is already known to the Potential Retailer (as evidenced by the Potential Retailer's written records) at the time of its disclosure to the Potential Retailer by Shell; or
was lawfully acquired by the Potential Retailer from a third party without an obligation of confidentiality (as evidenced in the Potential Retailer's written records).

The Potential Retailer shall be entitled to disclose Confidential Information to the extent required by an order issued by a court of competent jurisdiction or any regulatory body having jurisdiction, provided that:

the Potential Retailer shall take reasonable steps to maintain the confidentiality of the Confidential Information by the court or regulatory body;
the Potential Retailer shall provide Shell with immediate written notice of any order for disclosure; and
the Potential Retailer consults with Shell on the advisability of taking legal steps to resist or narrow any such order.

If the Potential Retailer does not enter into a Commercial Agreement with Shell for the operation of a Shell-branded service station or other retail business:

the Potential Retailer shall not use any of the Confidential Information in furtherance of the Potential Retailer's business or otherwise; and
the Potential Retailer shall promptly redeliver to Shell all the Confidential Information or destroy or have destroyed any copies or other reproductions of the Confidential Information, whether in tangible or electronic form, together with such notes, reports, and all other electronically stored or written material whatsoever prepared by the Potential Retailer or on behalf of the Potential Retailer in connection with its review of the Confidential Information.

It is understood by the Potential Retailer that in providing the Confidential Information or any other information to the Potential Retailer, Shell makes no representation or warranty as to the quality, accuracy or completeness of the Confidential Information or other information provided by Shell. The Potential Retailer agrees that neither Shell nor anyone representing Shell, shall have any liability, whether direct, indirect or consequential, to the Potential Retailer or any of its Representatives for any errors or omissions or for any damages resulting from the use of the Confidential Information or other information provided by Shell, it being understood that only those particular representations and warranties which may be made to the Potential Retailer by Shell in a definitive agreement, when, as and if executed, and subject to such limitations and restrictions as may be specified in such definitive agreement, shall have any legal effect.

The Potential Retailer shall be liable for any breach of this Confidentiality Agreement by it, any of its Affiliates, directors, officers or other related parties or any of its Representatives. The Potential Retailer shall require all persons having access to the Confidential Information to comply with the provisions of this Confidentiality Agreement. The Potential Retailer shall take all reasonable measures including, but not limited to, court proceedings to restrain its Representatives and others subject to the Potential Retailer's control from unauthorized disclosure or use of the Confidential Information.

The Potential Retailer agrees that Shell could be irreparably injured by a breach of this Confidentiality Agreement and that monetary damages would not be a sufficient remedy. Consequently, the Potential Retailer agrees that in such event Shell shall be entitled to equitable relief, including injunctive relief without a showing of actual damages and specific performance. Such remedies shall not be deemed to be exclusive remedies for a breach of this Confidentiality Agreement but shall be in addition to all other remedies available at law or equity.

10.

Without limitation and in addition to any rights of Shell arising by reason of any breach hereof, the Potential Retailer shall (i) be liable to Shell and its Affiliates (as hereafter defined) for all costs, losses, damages (including legal fees on a solicitor and his own client basis) and expenses whatsoever which either of or both of them may suffer, sustain, pay or incur, and, in addition, (ii) indemnify and save harmless Shell and its Affiliates for all costs, losses, damages (including legal fees on a solicitor and his own client basis) and expenses whatsoever which one or more of them may suffer, sustain, pay or incur, arising out of any breach of or noncompliance with this Confidentiality Agreement by the Potential Retailer, its Affiliates, directors, officers or other related parties or its Representatives.

For the purposes of this Confidentiality Agreement, "Affiliate" means any body corporate or partnership that directly or indirectly controls, is controlled by or is under common control with Shell or the Potential Retailer (as the case may be), and "control" means an ability to exercise a majority voting power or the ownership of the majority of issued share capital or units, or the power to direct or cause a direction of the management of such corporation or partnership by contract or otherwise.

11.

The Confidential Information is the exclusive property of Shell. No interest, license or any right respecting the Confidential Information, other than as expressly set out herein, is granted to the Potential Retailer under this Confidentiality Agreement. Confidential Information is provided at the sole discretion of Shell and nothing in this Confidentiality Agreement will obligate Shell to disclose specific Confidential Information to the Potential Retailer.

12.

The parties hereto understand and agree that unless and until a Commercial Agreement has been executed and delivered between the parties, no relationship, contract or agreement between the parties hereto shall be deemed to exist and neither party shall be under any legal obligation or commitment of any kind whatsoever to enter into discussions or any further agreement. Shell shall not be precluded from negotiating or entering into any agreements or obligations with any other parties, including in relation to sites discussed with the Potential Retailer, merely by reason of the execution of this Confidentiality Agreement or the disclosure of Confidential Information.

13.

Neither this Confidentiality Agreement nor any communication of the parties hereto shall be deemed to create any obligation or liability of either party to proceed with any further commercial arrangement until the parties so agree in writing.

14.

This Confidentiality Agreement shall not be assigned by the Potential Retailer without Shell’s written consent, which consent may be unreasonably withheld.

15.

This Confidentiality Agreement shall be binding upon and enure to the benefit of the parties hereto and their respective successors and permitted assigns.

16.

This Confidentiality Agreement shall commence on the date hereof and shall continue in full force and effect for a term of five (5) years; provided that this Confidentiality Agreement shall automatically terminate upon the parties entering into a Commercial Agreement, at which point any confidentiality requirements set out in such Commercial Agreement will apply to the Confidential Information. Notwithstanding the foregoing, in the event the parties do not enter into a Commercial Agreement, all trade secrets forming part of the Confidential Information disclosed to the Potential Retailer shall be safeguarded by the Potential Retailer as required by this Confidentiality Agreement in perpetuity or for so long as such information remains a trade secret under applicable law, whichever occurs first.

17.

This Confidentiality Agreement shall be governed by and construed in accordance with the laws of the Province of Alberta without reference to conflict of laws rules or principles, and each party submits to the jurisdiction of the courts of the Province of Alberta for the interpretation and enforcement thereof.

18.

No amendments, changes or modification to this Confidentiality Agreement shall be valid unless the same are in writing and signed by a duly authorized officer or agent of each party. No act, failure to act or delay by a party in exercising any right, power or privilege hereunder shall operate as a waiver thereof, nor shall any single or partial exercise thereof preclude any other or future exercise thereof or exercise of any right, power or privilege hereunder. No waiver of any term of this Confidentiality Agreement shall be valid unless the same is in writing and is signed by a duly authorized officer or agent of the party waiving the protection of the term in question and any such waiver does not extend to any other matter of occurrence.

19.

Should any provision or condition of this Confidentiality Agreement be or become illegal or unenforceable, such provision or condition should be considered separate and severable from this Confidentiality Agreement and the remaining provisions and conditions of this Confidentiality Agreement shall remain in force and be binding upon the parties as though the severed provision or condition had never been included.

"By selecting, the Potential Retailer hereby agrees and accepts all of the terms and conditions associated with its use and receipt of the Confidential Information, as outlined in this Confidentiality Agreement."

Name: