Franchise Pre-Application Form
Please fill in the following details in order to qualify for possibility of getting a Franchise
* Required
Name (First and Last Name)
*
Your answer
Address
*
Your answer
City
Your answer
State
Your answer
Pin
Your answer
Email
*
Your answer
Phone Number
*
Your answer
Business Phone
Your answer
Home Phone
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Marital Status
Married
Single
Employment History
Your answer
Business History
Your answer
Educational Background
Your answer
Investment Capabilities
*
3-5 Lakhs
5-8 Lakhs
10-15 lakhs
20-50 lakhs
Constitution of Firm
*
Proprietor
Partnership
HUF
Pvt. LTD
Interests and Opportunities (If yes, please give the details)
Your answer
Will You be able to give your full - time commitment in running a successful ZenMeds Franchise?
Yes
No
Maybe
Information of Property
The following details are important for the consideration in granting a Franchisee
Location of the Property
(Please Specify the location Details)
City
*
Your answer
State
*
Your answer
Whether Near
(Please tick and give details)
Mall
Main Road
Residential Market
Shopping Center
Other:
Give description of location
Your answer
Whether the Property Is
Leased
Owned
Rented
Area
Urban
Semi-Urban
Rural
Backward
If rented, then rent and lock in period
Your answer
Property approved by Municipal Corporation Authorities
Yes
No
If yes, please state - nature of property
Commercial
Residential
Other:
Location Specific Details
Access to Public Transport
Yes
No
Parking Space
Yes
No
Signage Area
Yes
No
Reliable Electric Supply
Yes
No
Internet Service Available
Yes
No
Nearby Bus Stop/Railway Station
Yes
No
Nearest Bus Stop
Your answer
Declaration (I declare that the information in this application is correct and I authorize Zensark to conduct its own enquiries as to ensure the accuracy of these statements)
*
Yes
No
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