JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Haldiram’s Preferred Outlet Application Form
ADDRESS
Plot No. 145/146, Haldiram House, Bhandara Road Chowk, Old Pardi Naka, Surya Nagar, Nagpur, Maharashtra 440035.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Email *
*
Your answer
Name *
Your answer
Landline number
Your answer
Mobile Number *
*
Your answer
Address *
*
Your answer
Name of the interested Area, City , State, where you want to open the Outlet? *
*
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Marital status *
Single
Married
Clear selection
Property status *
Owned
Rented
Other
Clear selection
Education Qualification *
Your answer
Business Experience *
Your answer
Have you been a customer in any HALDIRAM’S OUTLET? *
Yes
No
Clear selection
If Yes. How many times and what product do you purchase often? *
Your answer
What will be the source of these funds? *
Your answer
What are your Financial expectations in the Haldiram’s Preferred Outlet (HPO)? Will you and your family completely depend on the income of Haldiram’s Preferred Outlet (HPO) ? What are the other sources of family income? *
Your answer
How Many Haldiram's Express Outlets you're applying for? *
Choose
5
10
15
20
Other
Investment Level
Choose
30 Lacs
40 Lacs
50 Lacs
60 Lacs
70 Lacs
80 Lacs
90 Lacs
1 Cr
2 Cr
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
