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FRANCHISEE APPLICATION FORM
Please fill this form to evaluate the viabilities of this project. Your valuable information will help us to give customised business proposal to entrepreneurs like you.
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Current Date
MM
/
DD
/
YYYY
Name
*
Your answer
Age
Your answer
Correspondence Address
*
Your answer
City / State
*
Your answer
Pin Code
*
Your answer
Email
*
Your answer
Website
Your answer
Mobile
*
Your answer
Tel
Your answer
Academic Qualification
*
Your answer
Work / Business Experience
*
Your answer
Do you or your partner / organization own a Franchisee for any other brand
Yes
No
Clear selection
If yes, which brand
Your answer
Amount available to be invested from own resource for this Business.
*
10-15 Lacs
8-10 Lacs
6-8 Lacs
4-6 Lacs
How soon you are willing to start the Center ?
Your answer
Cities / Location in which you would like to start the Clinomic Centre (in order of preference)
Your answer
REMARK
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