Bio-Data Form

Name of Distributorship: Type of Distributorship: --Select-- Proprietorship Partnership Cooperative Defence Services Project Address: City / Town / Tehsil: District: --Select-- Ajmer Alwar Banswara Baran Barmer Bharatpur Bhilwara Bikaner Bundi Chittorgarh Churu Dausa Dholpur Dungarpur Ganganagar Hanumangarh Jaipur Jaisalmer Jalor Jhalawar Jhunjhunu Jodhpur Karauli Kota Nagaur Pali Rajsamand Sawai Madhopur Sikar Sirohi Tonk Udaipur State:  Rajasthan Sales Zone: --Select-- Ajmer Alwar Bikaner Jaipur1 Jaipur2 Jodhpur Kota Udaipur Name of Proprietor / Partners: 1. Mr Ms Mrs Dr  2. Mr Ms Mrs Dr Name of Contact Person:     Mr Ms Mrs Dr Designation of Contact Person: Proprietor Partner Family Manager Contact Phone Number: Please include full STD Code with phone nos. (eg- 0291-2452154) Residence 1. 2. Office 1. 2. Mobile 1. 2. Email Address: 1. 2. Preferred Communication : Email Ordinary Mail Both