Branch Request Form
Please fill in accurate details for evaluation
1. Personal Information
Basic Details
Title
*
Select
Dr
Mr
Mrs
Ms
Full Name
*
Date of Birth
*
Gender
*
Male
Female
Address
*
Mobile Number
*
Email ID
*
Educational Qualification (Most Recent)
*
Qualification
Year
Institution
2. Current Occupation
Please select your current occupation
*
Service
Business
Both
If in Service
Name of Employer
*
Designation
*
Previous Work Experience
*
Period
Company Name
Designation
Key Responsibilities
If in Business
*
Company Name
Type of Entity
Nature of Business
Products / Services
Years in Business
No. of Employees
Turnover (Last 3 Years)
If yes, please share additional details
Additional Details
*
3. Proposed Centre
Structure of the Proposed Centre
*
Proprietorship
Partnership
Private Ltd
Public Ltd
Is the entity already in existence?
*
Yes
No
If yes, mention the name of the Firm / Company
*
Proposed Centre / Branch Name
*
Location Preference
State / Province
*
Select State
District
*
Select District
City / Town
*
Pincode
*
Branch Address
*
Proposed Timeline for Starting Operations
*
Immediately
Within next 3 months
Next 3 to 6 months
Do you already possess a site?
*
Yes
No
If yes, mention the address
*
4. General Information
Are you a Dayjoy Distributor?
*
Yes
No
If yes, mention your Distributor ID
*
Do you have any reference in Dayjoy?
*
Yes
No
Name
*
ID Number
*
Mobile Number
*
Do you have experience in the direct selling industry?
*
Yes
No
Name of Company
*
Total Years of Experience
*
Do you operate any branch of an existing direct selling company?
*
Yes
No
Branch Address
*
Investment (Rs)
*
How much are you ready to invest?
Investment Amount (Rs)
*
5. Account Details
Bank Name
Select Bank
Bank Branch
Account Number
IFSC Code
A/C Holder Name
Pan No
Note:
a) All information will be kept confidential and used only for evaluation purposes.
b) Please ensure that all details are accurate and complete.
Submit Branch Request
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