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FRANCHISEE REGISTRATION FORM
Preferred Customer/Independent Bussiness Promoter Registration
Sponsor Information
*
Member Id/ Refference Id
Member Name/ Refference Name
Personal Information
*
Membership Type
Individual Name
M/S - Company Name Sole Proprietorship
Company Name
*
Full Name
Mr.
Ms.
Mrs.
M/S.
Md.
Dr.
*
Father Name
*
Mother Name
*
Mobile NO
+91-INDIA
*
DOB
*
Gender:
Male
Female
Other
*
Marital Status:
Select Marital Status
Single
Married
Divorced
Widowed
Email ID
Pan No
*
Aadhaar No
Voter Id No
Citizenship Id
Rastriya Parichay Patra
ADDRESS INFORMATION
*
Country
--Select Country--
India
*
State
*
District
*
City
*
Pincode
*
Address
BANK INFORMATION
*
Account Holder Name
*
Account Number
*
Confirm Account Number
*
Bank Name
*
Branch
*
IFSC Code
Online Payment App
Select...
Paytm
Google Pay
Phone Pe
Whatsapp Pay
Enter Phone Number
NOMINEE INFORMATION
*
Nominee Full Name
Mr.
Ms.
Mrs.
M/S.
Md.
Dr.
*
Gender:
Male
Female
*
Relation With Nominee
--Select Relation--
Spouse
Child
Parent
Sibling
Friend
Brother
Other
*
Nominee Mobile No
Stockist Sales Model
*
Sales Model
Select...
Mobile Stockist
Stockist
Super Stockist
Sales Amount
Sales Commision
Payment Mode
Select...
Cash
Bank Deposit
Net Banking
Commission Mode
Select...
Wallet Deposit
Bank Deposit
SECURITY INFORMATION
*
Login Password:
*
Confirm Password:
I already have a stockership
Accept Agreement And Politics & Procedures then continue with signup
e-Pin No*
State*
District*