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Registration for Educators

General Information

Name of the Institute/Individuals Faculty *
(as it should appear on the invoice, documents)

Business Type *

Public Ltd

Pvt Ltd

Partnership

Proprietary

Company Registration Number (if applicable)

Registered Office address *

Correspondence Address
(if different from Regd office address)

Contact Details

Land Line Telephone number

Fax Number

Email ID *

Password *

Contact Person (Name) *

Contact Person’s Cell Number *

Office timing & weekly off (if any)

Website URL (if available)

Statutory Details

PAN number *

Service tax registration number *

Bank Details

Name of Bank *

Name & Address of the Branch *

Type of Account and Account Number *

IFSC code *

Business Information

Director/Partner/Proprietor’s name *

Date of establishment *

dd/MM/yyyy

Approx number of programs held in last 3 years
(give the year also).

Name/s of city/cities where you hold the courses

If you are Franchisee to any Institute,
Please name it & upload the certificate/s

Any additional information you may want to provide

I confirm that above information is true and correct.

Name & designation of signatory who confirms the correctness.

SUBMIT

Registration for Educators

General Information

Contact Details

Statutory Details

Bank Details

Business Information

COMPANY

What’s in for You

Customer Service

Payment Method

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Welcome to Focus Dental !!

Welcome to Focus Dental !!

Registration for Educators

General Information

Contact Details

Statutory Details

Bank Details

Business Information

COMPANY

What’s in for You

Customer Service

Payment Method

Stay Connected