Franchise Registration

Institute Information

Franchise Type *

Name of the Institute *

Year of Establishment *

Postal Address of the Institute *

Pin Code *

City / Town / Village

State Name & District Name *

State Sort Name & District Sort Name *

Date.Of.Registration * (dd/Mon/yyyy)

Mobile *

Email *

Information About Centre Head

Name of the Centre Head *

Designing / Position Hold *

State *

District *

Postal Address of the Centre Head *

Pin Code & Mobile Number *

Email & Date of Birth of the Centre Head *

Gender *

Educational Qualification of the Centre Head *

Experience of the Centre Head *

Marital Status & Religion of the Centre Head *

Upload Documents

Colour Passport Size Photograph of the Head *
(Only JPG,JPEG,PNG File Upload)

G.S.T. File*
(Only JPG,JPEG,PNG File Upload)

Trade License / Registration Certificate of The Institute *
(Only JPG,JPEG,PNG File Upload)

Colour Photograph of Lab Room *
(Only JPG,JPEG,PNG File Upload)

Declaration

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