Products
 

FRANCHISEE APPLICATION FORM

We are selling our products through a network of franchisees. So come and join our network for great success.


Personal Information :-
Name of firm: *
Contact Persons: *
Mailing Address: *
City *
State
STD Code
Mobile
Phone (O)
Fax
Email *
 

 If Already In Business :-
C.S.T.No Date
L.S.T. No Date
D.L. No Valid upto
Constitution: Limited  
Pvt. Ltd.
Partnership
Proprietorship
No. Of Directors/Partners
No. of Employees
Experience in Pharmaceutical
Present Investment
 

 If Pharma professional :-
Age yrs.
Qualification
Experience in Pharmaceutical trade: yrs.
Proposed investment for MML:
Names & details of the Pharmaceutical units being dealt with:
1) 2)
3) 4)
Last year's turnover
Expected current year's turnover:
 

 If going to start new business what sales do you :-
Expect from your area
Current Area Covered:
Storage facility: Own
Rented
Storage Area (Sq. Ft.):
Area in your state you like to work:
In 20 words write what do you expect from us and what is your ambition: