EUREEKA EDUCATION AND SERVICES

FRANCHISEE FORM

Categories of Franchise

Institute Id

Institute Owner Name

Institute Name

Date of birth

Pan Number

Aadhar Number

Institute Full Address

Pincode

Upload Image of franchise Owner

Select State

Select District

Number of instructor

Number of class rooms

Space of Center

Whatsapp Number

Contact Number

E-Mail ID

Qualification of institute head

Reception

Staff Room Yes No

Water Supply Yes No

Toilet Yes No

Username

Password