DICE

FRANCHAISE APPLICATION FORM

Contact Details:

Date of Application:

Name of Center :

Contact Person :

Mobile No:

(Alternate Mobile No)

Email Id :

Type of Center: :: New Existing

Year of Establishment: -

Nature of Work:

Last Qualification of Person:

Aadhaar No:

Pan No:

Reference Id:

Service Type:

COMMUNICATION ADDRESS :-

PLOT NO:-

AT:-

POST:-

VIA:-

THANA:-

BLOCK:-

DIST:-

LAND MARK:-

STATE:-

PIN:-

FACILITIES AVAILIABLE:-

1.No of Computer System:-

2.No of Printer and Scanner:-

3.No of Seats:-

3. No of Employee:-

3. Space of office:-

Declaration

It is my heartily Confirmation that the above furnished data given above is true & honest of best of my knowledge & I given my data by filling the above form as my application to Digital Service Point & Click on Submit option below indicates agree & accept the all the term & condition for DSP of Digital Service Point .