2_158
DESCRIPTION
Ap Online ApplicationTRANSCRIPT
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Application No:
APPLICATION FOR MEESEVA FRANCHISEE AUTHORIZED AGENT
Contact No: .
Mail ID: .
Applying for the Municipality / Corporation : Tirupati [ ]; Chittoor [ ]; Nagari [ ];
Punganur [ ] ; Palamaner [ ]; Madanapalli [ ]
Applying For The Location / Area :
[for DeGS Sanctioned Locations only]
APPLICANT NAME :
APPLICANT FATHER / HUSBAND NAME :
APPLICANT PARMANENT ADDRESS :
APPLICANT PRESENT ADDRESS :
APPLICANT Educational & Tech., Qualifications:
Experience if any :
GENDER :
RELIGION & CASTE :
ANY Room is available at applying Location : YES [ ] ; NO [ ]
IF YES, Room Size / Area [in Sq.ft.] : Width: Ft X Length: Ft =_______Sq.ft.
Give Full Address Of The Room :
Details, If any existing business in this Room :
Signature of the Applicant
Application will reach on or before 15.06.2015 to
the Project Manager, HCL Infosystems Ltd., C/o. Mee Seva, Municipal Office Premises, Tirupati
Acknowledgement
Application No : Applicant Name :
Applied Municipality: Applied Location:
Sign: