FRANCHISEE PRELIMINARY CONSIDERATION FORM

Name Mr. Mrs. Ms. Spouse Address   State (Select) ANDAMAN AND NICOBAR ISLANDS ANDHRA PRADESH ARUNACHAL PRADESH ASSAM BIHAR CHANDIGARH CHHATISHGARH DADRA & NAGAR HAVELI DAMAN & DIU DELHI GOA GUJARAT HARYANA HIMACHAL PRADESH JAMMU & KASHMIR JHARKHAND KARNATAKA KERALA MADHYA PRADESH MAHARASHTRA MANIPUR MEGHALAYA NAGALAND ORISSA PONDICHERRY PUNJAB RAJASTHAN SIKKIM TAMILNADU TRIPURA UTTAR PRADESH UTTARANCHAL WEST BENGAL Zip Country India Overseas Ph: (Res) Ph: (Off) Home Own Rent Email ID Mobile Best Time to Call At Home At Office   Date of Birth Occupation Annal Income Employer Address   Marital Status Married Single Widowed Divorced Children Yes No No Age Territory of interest Unit(Particuls Area) Franchisee District Franchisee State( Master) Franchisee Country Franchisee   Time Frame to open you business ASAP 1-3 Months 4-6 Months 6+ Months Would you work the business Full Time Part Time With Partners Capital to Invest 10,000 25,000 50,000 Education Level High School Graduate P-Graduate Degree Earned Product Interested Kids English Program Handwriting Calligraphy Memory Techniques Vedic Maths Kalfun Schools No. of Schools in which this program will be introduced --Select-- 1 2 3 4 5 Name & Addresses of School No. of students in each School with respective standard / grade Standard / Grade for which Abacus programe will be introduced How the course will be introduced Separate Course Part Of Curriculum Special experiences / education / training related to our Franchisee if any Have you ever owned and operated your own business Yes No If yes Describe Remarks By signing below, I understand and agree that all confidential information obtained directly or indirectly by me, or conveyed to me by JAYAVIDYA EDUCATION & LEARNING SYSTEMS and its exployees, agents or franchisees, shall remain confidential forever. Further I agree not to divulge any confidential information to any other person or entity, except for my professional advisors or use such information directly or indirectly in competition against JAYAVIDYA EDUCATION & LEARNING SYSTEMS. E Signature Date