Action Time

(Firstname)

(Middlename)

(Surname)

Address *

Phone *

Email *

DOB *

Your social status * Any past criminal record?Are any criminal proceedings pending against you in any courts in India?Have you ever been charged for any unlawful acts?

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) ProprietorshipPartnershipPrivate limited

Is the Proprietorship/Partnership/Private limited already in existence * YesNo

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? * YesNo

If yes, provide details: *

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.*