Admission form

Authorization Application Form

DATA SHEET

1. Name                 :         ………………………………………………….

2. Address               :         ………………………………………………….

                                     
                                      ………………………………………………….

3. Phone                 :         (Off) …………………… (Res) ………………….

4. Name                 :         ………………………………………………….

5. Educational Qualifications

6.

No	Qualification	Year of Passing	Name of Institute
1
2
3

Family Background

No	Member Name	Relation	Profession
1
2
3

7.

Name of Bussiness	Year of Establishment	Name of Company	Principal Product	Annual Turnover	Ownership Partnership/Private
1
2

8. Work Experience

Duration	Name of Organization	Designation	Responsibility
1
2
3
4

9. Your Professional Background includes (Tick one applicable)

1. Marketing and sales                               Y/N              ………………….
2. Software Training                                  Y/N              ………………….
3. Teaching                                              Y/N              ………………….
4. Profit center management                       Y/N              ………………….
5. Use of Computers                                 Y/N              ………………….
6. Small Business Administration                  Y/N              ………………….

10. Financial Status

1. If holding a bank account                       Y/N              …………………
2. Name of Bank ………………………………………………………………….
3. Existence of immovable assets

• Insurance                1.       Value …………………………………………..

2.       Date of Maturity ………………………………

• Land                                Value ………………………………………….

     4. Amount to be invested                  ………………………………………………..

     5. Sources of funds for investment

1.    …………………………………………………….

2.    …………………………………………………….

3.    …………………………………………………….

1. Balance sheet of previous two years to be attached.

11. If already running a centre

            A. Hardware

Details of available H / W	Value of available H / W

            B. Available Software                   ………………………………………………….

                                                          ………………………………………………….

                                                          ………………………………………………….

12. Centre details

1.  Prospective city / town for Center            : …………………………………………..

2.  Proposed Location                                 : …………………………………………..

3.  Available area                                       : …………………………………………..

4.  If available area is of self or on lease                 : …………………………………………..

5.  If the proposed Center would be on proprietorship or on partnership basis or a private Limited Firm                                                              : …………………………………………..

     If Partnership, Name of Partners:

                        1………………………………………………….

                        2………………………………………………….

                        3………………………………………………….

     (Attach copy of partnership deed)

6.  Estimated Targets (annually)

             

              Year                                                   No. of Students

                 

                   First Year                                   ……………………..

                   Second Year                               ……………………..

                   Third  Year                                 ……………………..                

13. Your Market survey

            1. Population of City/Town                               : ……………………………….

            2. No. of schools and colleges in the area           : ……………………………….

            3. Existing possible competitors                         : ……………………………….

            4. Per capita income of the location (approx.)      : ……………………………….

14. How soon can you start                                             : ……………………………………….

Date                                                                       (Signature/full Name)

Declaration

I ……………………………………… Responsible office bearer of ………………… Hereby declare

that  I have gone through the EDGE CLASSES packages and have understood the provisions of  EDGE LEARNING centre and I agree to abide by them.

Date :                                                                     (Signature/Full Name)

Place: