National Digital Literacy Society

APPLICATION FORM FOR FRANCHISE AFFILIATION

Fill up the form & send us details for franchise approval
(*) Fields are mandatory!

Location Details

State

District

City / Town / Village

Institute Information

Name of the Institute

Year of Establishment

Status of The Institution

P.O.

P.S.

Postal Address of the Institute

Institute Contact No. (Phone 1)

Phone 2

Email ID

Username Choose a unique username for login.

Password Minimum 6 characters.

Information About Centre Head

Name of the Centre Head

Position Held

P.O.

P.S.

Address of the Centre Head

Mobile

Email of the Centre Head

Date of Birth of the Centre Head

Nationality

Religion

Gender

Documents

Color Passport Size Photo of the Centre Head JPG, PNG, GIF (Max 2MB)

Voter Card of the Institute Head JPG, PNG, GIF (Max 2MB)

Pan Card of the Institute Head JPG, PNG, GIF (Max 2MB)

Trade License of the Institute JPG, PNG, GIF (Max 2MB)

Color Photo of Office Room JPG, PNG, GIF (Max 2MB)

Color Photo of Practical Room JPG, PNG, GIF (Max 2MB)

Color Photo of Theory Room JPG, PNG, GIF (Max 2MB)

Declaration

I hereby certify that the context stated above are correct and true to my knowledge and belief and hereby confirm that our Organization / Society / Trust is free from any legal / official disputes whatsoever. I accept that any facts stated above, if found incorrect, will automatically result in cancellation for nominations associate. However, I will have no right whatsoever to fight / challenge legally against the judgment in any court of law. All disputes are subject to Malda Jurisdiction only.

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