Apply for

2. 1 1 1 21 .
Franchise Application Form:
Guidelines:
1. Please enter all relevant details. Do not keep any details
vacant/unfilled. Please paste
2. In case of questions with multiple options, please tick the your passport
appropriate answer. size photograph
3. In case you wish to provide any additional information, please here
attach a separate sheet.
4. Attach your current updated CV and business card along with
this application form.

Franchise Application Form:

Title (Dr./Mr./Miss./Ms.) Mr
Full Name: Amit Agarwal
Address: MG Road, Birpara, PIN-735204

Telephone/Mobile no. 9832082834

Email: Aamit033@gmail.com
Date of Birth: 21-12-1993
Gender: M F (Circle as appropriate)
married: Y N (Circle as appropriate)

SECTION: PERSONAL FACT SHEET

Education Qualification (beginning with most recent)

Qualifications Year of Passing Name of the Institute

Current Occupation: (Please tick)

A) Service B) Bussiness C) Both

To be filled in by those in service
Name of the current employer:
Designation:
Previous Work Experience:

Period Organization Name Designation Responsibilities

All informtion provided here will be kept confidential and will not be used for any
other purpose to be filled in by those in business:

Company Proprietary/ Nature of Products/ Number Turnover (Rs.)

Name(s) Partnership/ Business Years in
Services Business of people
Private Ltd./ offered Employed
Public Ltd.

Last 3 Year

Does your professional background involve any of the following? (Please tick the
appropriate box)

1.Marketing/ Sales 2.Health care

3.Education/ Training 5.Profit center Management

5.Small Business Mgmt.

Are you currently associated with any professional group/ association?

Yes No

If yes, give details:

SECTION II: THE PROPOSED CENTER?

How do you propose to set up the center?

Proprietorship Partnership Private Ltd.

Public Ltd. Society Trust

Is the Proprietorship/Parnership/Company/Already in existence?

Yes No

If yes, what is the name of the Business/Firm/Company

City Town where you propose to setup the new venture Birpara
Located in the state of West Bengal
when do you propose to setup the new venture?

With in 3 months Next 3 to 6 month Immediately

Ple a s e m e n t ion t h e ar e a w h e r e you w an t t o w ork

____________________________________________
Do you already possess a site?

Yes No

All information provided here will be kept strictly confidential and will not be used for
any other purpose (If no, do you have as it in mind?)

Yes No

Please give details of the site:

Nature of Period of Lease Tiles/Carpet Area Location:

Agreement* Commercial Area/
Ownership/Rental/ Residential Area
Long Term Lease (Address)

From: MG Road,
Ownership To: 800 sq.ft Birpara

Incase you do not have a site, do you plan to take on rent?

Yes No

If yes, with in how many months?

How much funds are you willing to Invest?

1-5 Lakh 5-10 Lakh

10-20 Lakh 20-30 Lakh
 .// 8 9 ? 1 1 1 .9 1 4 2. 19 91 .99 9 .99

I would try my best and work hard to make this business a success.

9 4 91 .8 9 91 .99 8 .8

We have knowledge of the locality and areas surrounding. We can make use of our
reach to expand business.

Date: 14.05.2023

Signature: Amit Agarwal