Corus Centre of Excellence Skill Asia
A. ORGANIZATION INFORMATION
Name of Organization
Organization Type
Industry
Industry Type
Nature of Business
Email
Address
City
District
State
Country
Zip/Pin
Landline
Website

B. PERSONAL INFORMATION
Name
Designation
Age
Gender
Father/Husband Name
Address
City
District
State
Country
Zip/Pin
Landline
Cell No
Email
Highest Qualification

C. BUSINESS EXPERIENCE D. PROPOSED FRANCHISE CENTRE
Type of Franchise Centre Proposed
Location
Block
District
State
Zip/Pin
Country
Proposed Infrastructure
Types of Possession
Carpet Area(Sq.ft)
Which Floor of The Building
If Leased, then Lease Period FromTo
Detail Area Allocation & Strength of the Existing Infrastructure

No. of Class Rooms
Area Per Class Room(Sq.ft)
Capacity Per Class Room
No. of Computer Labs
No. of Computers Per Lab
Total No. of Computers

E. STRATEGIC INFORMATION
Promoters / Partners / Directors / Trustees / Society Members Details
Proposed Investment Capability
INR 40 lacs to 50 lacs
INR 30 lacs to 40 lacs
INR 6 lacs to 10 lacs
INR 5 lacs to 6 lacs
Sources of Funding:
Own Capital%
Loan From Financial Institute%
Other Sources%
(if others, then please specify)
Legal details of the Organization
Company/Trust/Society, etc Registration Number
PAN Number
TAN Number
Service Tax Registration Number
When do you propose to set up the Franchise Centre?
Immediately
Within next 1 month
Within next 2 month
If applying for State Master Franchise, then; State Population
No.of Districts
No.of Blocks
No.of +2 Colleges
No.of Degree Colleges
No.of +2 Commerce Colleges
No.of Degree Commerce Colleges
If applying for District Nodal Centre, then;
District Population
No.of Blocks
No.of +2 Colleges
No.of Degree Colleges
No.of +2 Commerce Colleges
No.of Degree Commerce Colleges
If applying for Block Learning Centre, then;
Block Population
No.of Villages
No.of +2 Colleges
No.of Degree Colleges
No.of +2 Commerce Colleges
No.of Degree Commerce Colleges
Declaration:
I DECLARE THAT THE ABOVE DETAILS AND INFORMATION PROVIDED BY ME ARE TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF.
Date of Application:
Mode of Application:         Email PostIn Hand
Delivered to:
(If delivered through Email, then Email ID ELSE, If delivered by Post or Hand Delivery, then Name of the Member of Corus.
Signature with Seal
(If Delivered through Post or in Hand)