FRANCHISE APPLICATION FORM
LOCATION DETAILS
Name of Institution
Country
State
District
Panchayath / Muni. / Corp
Post Office
Pin Code
Place
Whether the Institution run by Society / Trust / company
Mode of Organization
Whether the Institution is running ASMI School if any? (Specify the Details including affiliation number)
    Facilities in the campus (Tick in appropriate)
Whether the Running agency has any Institution under SKIMV Board (Reg.No.194/85)
Is ASMI PPTC course running in your premise of 10 km
Is the Association running any other PPTC course under any other Agency (If so, state how the merging process is anticipated)
Coordinator
Coordinator Phone
Reason for planning the course under the Organization
DECLARATION
it's declared that the statement furnished above are true and the Organization is ready to abide the rules and regulations/ ideology of Samastha Kerala Jamiyyathul ulama in all aspect.
We, request you that you may consider our application this year itself

Date:

PRESIDENT / CHAIRMAN

Name:

Mob:

 

G SECRETARY/ CONVENOR

Name:

Mob: