Franchisee Application Form

Name*

MyKad No. *

Email address*

Address

Address Line 1

Address Line 2

City

Country

State or Region

Zip

Mobile No.*

Citizenship

Home/Office

No. Fax

Name of School / College / University

Present Occupation*

Company

Years Of Experience

Are you presently a Director of any company?

Yes

Company Name

Nature of Business

Proposed Location 1

Proposed Location 2

Type of Investment

Cash

Loan

Amount of cash available for investment

Any loan with bank? If yes please specify

Brief summary of your business experience

Why do you choose Education Industry?

Why do you choose Genius Aulad?

Have you attend any franchise course/training/seminar previously?

Yes

Are you human?*

This field should be left blank