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    Name :

    (Firstname)
    (Middlename)
    (Surname)
    Address *
    Phone *
    Email *
    DOB *
    Your social status *
    If you have ticked ‘Yes’ for any of the above options, please state details of the same here below: *
    How do you propose to set up the Company? * (Please tick)
    Is the Proprietorship/Partnership/Private limited already in existence *
    If yes, what is the name of the Business *
    IT-PAN number *
    How do you propose to raise funds for Anvayaa Franchise? *
    Own Capital
    Loans from Financial institutions
    Other sources
    Is your organisation accredited/affiliated to any other business similar to that of Anvayaa? *
    If yes, provide details: *

    Which are the Senior care businesses in your town/city/locality that you consider as major competitor? *

    NAME OF BUSINESS SERVICE MIX
    Have you been involved in any Franchise business in the past? If yes, please provide details. *
    Have you been associated in any way with the senior care service? If yes, please provide details *
    Tell us something about your personality - your hobbies, definition of excitement & thrill, your people skills, zeal to meet new people, public speaking abilities etc.*

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