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Franchisee/Renewal Application Form

Application for*

Study Center

Master Franchise

Center Renewal

Director/ Center In Charge Information

Director Name*

Father’s Name*

Dob *

Address *

City*

Dist*

State*

Pin Code*

last Academic Qualification:

Matric

Intermediate

Graduation

PostGraduation

others

Mobile*

Alternate Mobile*

Email*

Information About Institution

Wheather you are currently running a institute

Yes

Study Center name*

Address *

Location *

Block *

PO *

Dist *

State *

Pin Code *

Area *

Urban

Semi Urban

Rural

Total Carpet Area Sqft *

Number of Faculty Staff *

Number of Computer *

Number of Printer/Others *

Facilities Available at the ASC *

Power Backup

Drinking Water

Toilet

Parking Space

Owner Passport size photo *

Owner Signature *

Aadhar Card/Pan Card/DL/Passport/Bank Passbook *

Address proof of center- (Rent/ Lease then rent/Telephone/Electricity bill etc) *

Photographs of Institute*

Declaration

I Hereby declare that all the particulars stated in this application are true to the best of my knowledge and belier and have understood all the provisions as well as ruler and regulations of the organization and swear to abide by them, failing which organization reserve the right to take any action.
“Agreement for Authorization and Undertakings”

Our Tie Ups Company

GetIn Touch

Global Computer Saksharta Abhiyan (GCSA)
New Bypass Road, Near BSNL Exchange Office, In-front of HDFC ATM, Anisabad, Patna-800002

Phone: +91 9304318441, 0612-2250122

Email: info@gcsaindia.com

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