- Please enter all relevant details.
- Please tick the appropriate answer, wherever applicable.
- Attach your current profile, business portfolio and business card with this application form.
PLEASE WRITE IN CAPITALS LETTERS
SECTION I: PERSONAL INFORMATION
1. Qualification (beginning with the most recent):
2. Current Occupation: (Please Tick)
A) If in service, kindly fill the following details:
Kindly give 2 work references:
B) If in business, kindly fill the following details
3. Are you currently associated with any professional group/association in any form?
4. Does your professional background involves any of the following? (Please tick the appropriate box)
5. Any legal proceedings pending against you in India or abroad?
SECTION II: THE PROPOSED CENTRE
1. How do you propose to set up the centre?
2. Is the Proprietorship/ Partnership/ Company/ already in existence?
3. City/Town where you propose to setup the new venture
4. When do you propose to setup the new venture?
5. Do you already possess a Land/Campus/Site?
If yes, please give details of the site :
6. In case you do not have a site, do you plan to take on rent?
7. What efforts / initiatives would you put in to make this business a success?
8. State reasons why Dentedge Healthcare should consider you as a franchise?