Online Franchise Registration

Name *

S/O, D/O, W/O *

Date of Birth(MM/dd/yyyy) *

Email Id *

Contact No. *

Center Name *

Aadhar No. *

Select State *

Select District *

Pin / Zip code *

Address *

Block / Area *

Upload Photo of Director (50Kb) *

Upload Director Signature (50Kb) *

Upload Center Lab Photo (50Kb) *

Upload Center Class Room Pic.*