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Personal Details of Center Head

Apply For Which Level*

Name*

Father's/Husband's/Guardian's Name*

Date of birth*

Email Id*

Mobile No.*

Qualification*

Computer Qualification*

Address*

Centre Infrastructure Details

No. of Thery Room*

No. of Practical Room*

No. of Office Room*

Total Carpet Area in sq. ft.*

Internet Connection Type*

No. of Operational Computer*

No. of Laptot*

No. of Printer*

No. of Scanner*

No. of Staff*

No. of School in your area*

No. of College in your area*

Toilet*

Centre Communication Details

Centre Name*

Contact No.*

Email Id*

Land Mark

State Name*

District Name*

Block/Municipality Name*

Panchayat Name/Ward No*

Pin Code* :

Address*

Bank details in the Name of Centre or Centre Owner

Account Holder Name*

Account No.*

Account Type Saving/ Current*

Bank Name*

Branch Name*

IFSC Code*

Required Documents (Upload Scan Copy of Below Documents)

Photo of Centre Owner (300 Kb)*

Trade License (300 Kb)*

Voter Id of Centre Owner (300 Kb)*

Aadhaar Card of Centre Owner (300 Kb)

Pan Card of Centre Owner (300 Kb)*

Bank Passbook/Cheque of Centre Owner (300 Kb)*

Room Agreement (If rented) or Ownership Copy (300 Kb)

Computer Certificate (300 Kb)

Declaration

The parties agree that the courts at Malda will have exclusive jurisdiction in respect of any claim or dispute between the parties in connection with or arising out of this agreement including any dispute as to the existence or validity hereof.

Agree

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MAHATMA GANDHI BRAIN COMPUTER SHAKHARTA MISSION

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Franchise Registration Confirmation