Franchisee Application - PMK National Youth Computer Centre

Centre Registration Form cum Franchisee Application Form

Institute Location Details

Select State:

Name of District:

Location / Area

Landmark

Post Office:

Police Station:

Pin:

Area Type

Area Under

Name of Panchayat / Municipality

Institute Type

Date of Application as ATI:

Institute Information

Name of Institute

Office Contact Number:

Email Id:

Website

Applicant Information

Applicant Name

Complete Postal Address of Applicant:

* Pin:

* Contact No:

* Email Id:

Gender:

Nationality:

Religion:

* Date Of Birth:

Marital Status:

* Last Academic Qualification:

* PAN Number

Residential Proof

Residential Proof Document Number

Infrastructure Information of Centre

Total Area (In Sq. Feet)

Number of Floor

Number of Theory Room

Number of Practical Room

Sitting Capacity in Theory Room

Total Number of Computer

Drinking Water Facility

Toilet Facility

CCTV Availibility

Library Facility

Power Backup

Total Number of Faculty (Both Teaching & Non Teaching Staff)

Upload Documents (JPEG or PDF Document Only)

* Applicant Passport Photo: (JPEG Only)

* Applicant PAN CARD : (Max. 2MB)

* Applicant Document Proof: (Max. 2MB)

Trade License: (Max. 2MB)

Declaration (Mandatory)

I am declare that, I was read and Agree With the Franchisee Terms & Condition of PMK National Youth Complete Centre.

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