Sajeevan Organic

Name of the Applicant *

if associated with any Political/Social/Religious Institution then give Details

Enter email-id

Enter contact no

District *

State *

Location for store *

Pincode

Proposed Area *

Expected Investment *

Number of Sajeevan Centers in the Name of Applicant or his family/Relatives *

Does Applicant have any other business, If yes then please provide details *

Sajeevan Exclusive store