Name of the Applicant

Address of the Applicant

Educational Qualification

Date of Birth

Contact Number

Email

Nature of Work Nature of Work Business Self Employee Government Employee Retired Employee Homemaker

Sector

Work Experience (number of years)

Currently are you running any business or organisation? Currently are you running any business or organisation? Yes No

Name of the current Business or Organisation

Type of the Business or Organisation Type of the Business or Organisation Proprietary Partnership Private Limited NGO Others

Nature of Business Nature of Business Manufacturing Services

Business Experience (number of years)

Qualification Qualification UG PG Others

Franchise Model Franchise Model FICO (Franchisee Invested and Company Operated) FOFO (Franchisee Owned and Franchise Operated)

Do you need a bank loan for investment? Do you need a bank loan for investment? Yes No

How much loan do you prefer? How much loan do you prefer?3 lakhs5 lakhs10 lakhs15 lakhs

Are you an IT Assessee ? Are you an IT Assessee ? Yes No

Interested State for Franchise Interested State for FranchiseTamilnaduKeralaAndhra PradeshKarnatakaNorth India

Interested Region for Franchise in Tamilnadu Interested Region for Franchise in TamilnaduAriyalurChengalpetChennaiCoimbatoreCuddaloreDharmapuriDindigulErodeKallakurichiKancheepuramKarurKrishnagiriMaduraiMayiladuthuraiNagapattinamKanyakumariNamakkalPerambalurPudukottaiRamanathapuramRanipetSalemSivagangaiTenkasiThanjavurTenkasiThanjavurTheniThiruvallurThiruvarurTuticorinTiruchirappalliThirunelveliTirupathurTiruppurTiruvannamalaiThe NilgirisVelloreViluppuramVirudhunagar

Interested Region for Franchise in Kerala Interested Region for Franchise in KeralaAlappuzhaErnakulamIdukkiKannurKasaragodKollamKottayamKozhikodeMalappuramPalakkadPathanamthittaThiruvananthapuramThrissurWayanad

Interested Region for Franchise in Andhra Pradesh Interested Region for Franchise in Andhra PradeshSrikakulamVizianagaramParvathipuram ManyamKakinadaDr.B.R.Ambedkar KonaseemaAnakapalleVisakhapatnamEluruKrishnaEast GodavariGunturPalnaduBapatlaPrakasamN.T.RAnnamayyaKadapaKurnoolPuttaparthiPaderuChittoorNelloreTirupatiAnanthapuramuBhimavaramNandyal

Interested Region for Franchise in Karnataka Interested Region for Franchise in KarnatakaBengaluru UrbanBelagaviBidarChamarajanagaraChikkamagaluruDakshina KannadaDharwadKalaburagiHaveriKolaraMandyaRaichurShivamoggaUdupiVijayanagaraUttara KannadaYadgiriTumakuruRamanagaraMysuruKoppalaKodaguHassanGadagDavanagereChitradurgaChikkaballapuraVijayapuraBallaryBengaluru RuralBagalkote

Interested Region for Franchise in North India Interested Region for Franchise in North IndiaJaipurAgraDelhiKanpurAmritsarLucknowChandigarhAllahabadSrinagarGurgaonAligarhKotaLudhianaVaranasiPatnaJodhpurGhaziabad

Interested Territory for Franchise (Place where to start our franchise)

When do you propose to setup the new venture? When do you propose to setup the new venture? Immediately Within next 1 month Within next 3 months Next 3 to 6 months

Franchise taken by Franchise taken by Individual Company

Name of the Person (Full Name)

Aadhaar Number

Pancard Number

Full Address

Name of the Company

DIrectors and prograters

Is this company registered under GST? Is this company registered under GST? Yes No

Enter GST Number

Partnership Agreement Signup Date with Learnova

Franchise Fee Payment Method Franchise Fee Payment Method Cheque NEFT RTGS IMPS

Please enter Bank Name of the Cheque

Please enter Account Name of the Cheque

Please enter the Cheque Number

Please enter Date of the Cheque

Please enter Amount of the Cheque

Please Enter UTR no

Please Enter Date of the Transaction

Please Enter Amount of the Transaction

Space Available Space Available Yes No

Space in Sq. Ft.

Do you want to search the place with the help of Learnova? Do you want to search the place with the help of Learnova? Yes No

Nature of Space Agreement Nature of Space Agreement Ownership Rental Lease

Period of agreement

Classification of the place Classification of the place Residental Commercial Education

Proximity from Main Road Proximity from Main Road On Main Road Near Main Road(with in 500m) Away from Main Road(more than 500m)

Have you applied for any other franchises in any of the products in the last two years? Have you applied for any other franchises in any of the products in the last two years? Yes No

If yes, which franchises?

Reasons for wanting to become a Learnova Centre Franchise

What efforts/ initiatives would you put in to make this business a success?

What motivates you? What motivates you? Prestige of doing own business Good feeling of doing art business Market Share Success Social Contributions [Providing Jobs]

Expectations from business Expectations from business Turnover Profit Quarterly cash flow

Why did you choose Learnova? Why did you choose Learnova? Low Risk Like Learnova Concepts Want to do Edutech Business

Declaration Declaration I hereby certify that the context stated above are correct and true to my knowledge and belief and hereby confirm that myself / my organisation / my company / is free from any legal /official disputes whatsoever. I accept that any facts stated above. If found incorrect will automatically result in cancellation for franchisee.