Name of Applicant
Name of Company/Firm
PAN Card No.
Province
District
Your Email
Mobile No.
Landline No.

Do You Have any Experience of FMCG retails or experience in this domain YesNo

If Yes, Brief History of the Product of the retails Business you have done so far
For how many years of retail business experience do you have
Last One Year Turnover (in lakh):
Investment Capacity (in lakh): 2-3 lakh3-5 lakh5-10 lakh10-20 lakh25 lakh and above
Area Warehouse (in sq. ft.) 200–500 sq ft500-800 sq ft800-1200 sq ft1200-2000 sq ftAbove 5500 sq ft
No. of Salesperson:
No. of Transport Vehicles Delivery Van, Jeep or Truck (Don't include two wheelers)
Are you already engaged with Patanjali Pariwar? YesNo
If Yes, then mention the cadre Karyakarta / Yoga teacher/ Patanjali AK,SK / others. If other please fill KaryakartaYoga TeacherPatanjali Arogya KendraPatanjali Seva KenderaOthers

If Yes, Brief History of the Product of the Distribution Business you have done so far.

Kindly attach following documents:

PAN Card
Address Proof
Company/Firm registration certificate
Address

The person who deals with the trade of information’s business are eligible to fill from because our organization is a social and spiritual organization.

I Agree with Term and condition

NOTE: Patanjali Ayurved Private limited Reserves the right to reject or accept any application without assigning any reason, however the information given in this form would not use anywhere and would be highly confidential.