FRANCHISEE APPLICATION

NAME OF THE APPLICANT INSTITUTE :
ADDRESS OF THE APPLICANT INSTITUTE

: ______________________
____________________
_____________________
_____________________
PIN CODE______________
CONTACT NO:
____________ FAX ______________
Email
: ___________________
LAND MARK
____________________
NEAREST RAILWAY STATION: _________ ______ â Kms : NEAREST BUBT OP ______________
INFRA STRUCTURE DETAILS OF THE INSTITUTE :
TOTAL AREA : __________________ (IN SQ FT)
NO.OF CLASS ROOMS : __________ Nos _______________ ( IN SOFT)
NO OF PRACTICAL ROOMS : _____________ Nos _________ (IN SOFT)
NO OF SYSTEMS : _____________ NOS
WHETHER UPS A VAILABLE? IF SO, GIVE DETAILS ____________
WHETHER INTERNET CONNECTIONS AVAILABLE? IF SO, GIVE DETAILS____________
WHETHER GENERATOR/INVERTER FACILITY AVAILABLE _____________
STAFF DETAILS
TEACHING STAFF
: ______________ NOS
NON TEACHING STAFF : ______________NOS
QUALIFICATION DETAILS OF STAFF
S.NO
NAME DESIGNATION
QUALIFICATION

DETAILS OF REPRESENTATIVE OF THE INSTITUTIONS
DESIGNATION ____________
NAME :
AGE & DATE OF BIRTH :
RESIDENTIAL ADDRESS :
CONTACT NOS : OFFICE _____________
RESIDEME ______________
MOBILE _____________
E Mail
_____________

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