Partner Forms

Unboxing Radium Box

Thank you for your interest in Radium Box. Please fill up the application form below for authorized franchisee.

NOTE :-  All (*) marks are mandatory to fill the details

Applicant Information
Full Name * Father Name*
Date of Birth(DD/MM/YYYY)*
Age
Gender* Email-id*
Educational Qualification:* Specialization*
Contact Number*
Landline Number
Business Information (*)
Type of Business(pvt.ltd or etc) Current Business:
Year of Incorporation Office Address
District State
Pin Code Mobile Number
Infrastructure Details (*)
Computer Yes No Printer with Scanner Yes No
Internet Yes No Smartphone Yes No
Electricity Yes No Office Area (100 sq.feet) Yes No
KYC Details
PAN Number: Upload PAN
Address Proof
Upload Add. proof
Bank Details (*)
Bank Name Account No.
Branch Name IFSC Code
Account Type Cancelled Cheque
Upload Documents (*)
Photo
Signature