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Ayurhealthclub.

com

AYUR HEALTHCLUB FANCHISE APPLICATION FORM


Guidelines:1. Please enter all relevant details. Do not keep any details vacant / untitled.
2. In case of questions with multiple options, please tick the appropriate answer.
3. In case you wish to provide any additional information, please attach a separate
sheet.
4. Attach your current updated CV and business card along with this application form.
PLEASE WRITE IN BLOCK CAPITAL
Title (Dr/Mr/Mrs/Miss/Ms)__
Full Name and Address:_________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Please paste authorised signatory/Key person passport size photograph here


Mobile/Telephone ______________________________
Email. ________________________________________
Date of birth: _________________
TIME OF BIRTH _____(AM/PM)_______ PLACE OF BIRTH_________________
Gender: M F ________ Married: Y N______________
SECTION I: PERSONAL FACT SHEET
1. Educational Qualification (beginning with the most recent):___________________
Qualification Year of passing Name of Institution ___________________________
2. Current Occupation: (Please Tick)_______________________________________
a.) Service b.) Business. C.) Both. ________________________________________
To be filled in by those in service
Name of current employer : _____________________________________________
Designation : ________________________________________________________
Previous Work Experience : ______________________________________________
Period of service in Organization & Designation______________________________

_____________________________________________________________________
Copy Rights reserved
www.ayurhealthclub.com SHIVAG TRADE AND
BUSINESS SERVICES PVT LTD No 2201, World Trade Center, 22nd Floor
26/1, Dr Rajkumar Road Malleshwaram West Bangalore 560055 Karnataka India

To be filled in by those in Business


Company Name(s) __________________________________________________
Proprietary/Partnership/Private Ltd/Public Ltd_____________________________
Nature of Business Products/Services_____________________________________
Employed Years in Business___________________________________________
Number of People Employed ________________________________________
Last year Turnover (Rs)______________________________________________
3. Does your professional background involve any of the following? (Please tick the
appropriate box)
1. Marketing/ Sales _____2. Software/Hardware/IT _____
3. Education/ Training _____4.Profit Center Management ____
5. Small Business Mgmt.______ 6. Other (specify)_____________
4. Are you currently associated with any professional group/ association? Yes/No
If yes, give details:
_________________________________________________________________
SECTION II: THE PROPOSED CENTER
1. How do you propose to set up the center? Proprietorship/ Partnership /Private Ltd/
Public Ltd. /Society Trust _____________________________
Is the Proprietorship / Partnership / Company/ Already in existence?
a.) Yes b.) No ________
If yes, what is the name of the Business/ Firm/ Company
_________________________________________
2.City / Town where you propose to setup the new venture
_______________________________
located in the state of ________________________________________________
3.When do you propose to setup the new venture?
Immediately Within next 3 months Next 3 to 6 Months _____________________
4. Do you already buy place for business a.) Yes b.) No_________________
5.If no, do you have a place for running business in mind? a.) Yes b.) No_________
6.Please give Address of the proposed Place _______________________________
7.Nature of Agreement
Ownership/Rental/ Long term Lease/Period of Lease Tiled /________________
8.Carpet Area of the Location ___________________________
9.Commercial Area/ Residential area______________________________
SECTION III
1. In case you do not have a site, do you plan to take on rent? Yes / No ____
If yes, within how many months? ________________________
2. How much funds are you willing to invest? ____________
___________________________________________________________________
Copy Rights reserved www.ayurhealthclub.com SHIVAG TRADE AND
BUSINESS SERVICES PVT LTD No 2201, World Trade Center, 22nd Floor
26/1, Dr Rajkumar Road Malleshwaram West Bangalore 560055 Karnataka India

3. How do you propose to raise the funds required for this Venture?
Own Capital %____________
Finance opted from our associates at http://funding.vigash.in %
Other sources %________________
If from other sources, please specify the source and attach a note on the background
of the person(s)/Institution._________________________
Copy Rights reserved www.ayurhealthclub.com SHIVAG TRADE AND
BUSINESS SERVICES PVT LTD No 2201, World Trade Center, 22nd Floor
26/1, Dr Rajkumar Road Malleshwaram West Bangalore 560055 Karnataka India
Copy Rights reserved www.ayurhealthclub.com SHIVAG TRADE AND
BUSINESS SERVICES PVT LTD No 2201, World Trade Center, 22nd Floor
26/1, Dr Rajkumar Road Malleshwaram West Bangalore 560055 Karnataka India
4. What efforts / initiatives Would you put in to make this business a success?
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

5. State reasons ayurhealthclub.com should considered you as a franchisee partner.


_________________________________________________________________
_________________________________________________________________
__________________________________________________________________

Date: ____ _____ ________ Signature: ___________________

Documents Required For Franchise Form


Address Proof (Any 1 of the Following) or DV NO_________________verified
with www.dataisverified.com
1)Adhar Card
2)Electricity Bill
3)Bank statement,
4)Gas bill,Rental
5)Rental Agreement,
6)Declaration form Charted Accountant
___________________________________________________________________
Copy Rights reserved www.ayurhealthclub.com SHIVAG TRADE AND
BUSINESS SERVICES PVT LTD No 2201, World Trade Center, 22nd Floor
26/1, Dr Rajkumar Road Malleshwaram West Bangalore 560055 Karnataka India

Identification Proof or DV NO_________________verified with


www.dataisverified.com
1)Voter Id
2)Pan Card is mandatory
3)Passport
4)Driving License
5)Adhar Card
One Time Franchise fee for each pin code area in Rural Area is Rs 300000/- and
urban area is Rs 600000/- and we provide rebate for women entrepreneurs 10% . One
time Franchise Fee payment will enable additional discount of 10%
Note:
a)Every year Renewal requires 12000 for which Rs 1000 will be deducted on
franchise payment or collected from franchises.
b)Discount of Rs 2000 is available who pays Rs 12000 at the time of renewal on one
go
_____________________________________________________________________

For office use only :

Acknowledgment
I Here by declare that we have received the fallowing documents from
Mr/Ms ________________________________________
Address Proof __________________________________
Id Proof _______________________________________
Signature Proof_________________________________
Number of Cheque,s received from Customer and Cheque number's
________________________________________________________
________________________________________________________
_______________________________________________________

Authorized Signature:
Date:
___________________________________________________________________
Copy Rights reserved @ 2014 www.ayurhealthclub.com SHIVAG TRADE AND
BUSINESS SERVICES PVT LTD No 2201, World Trade Center, 22nd Floor
26/1, Dr Rajkumar Road Malleshwaram West Bangalore 560055 Karnataka India

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