Application Form

Name of Candidate Anivesh Kumar
911041390473

Student Photo Not Available
Mother's Name Shushila Devi
Father's Name Nawal Kishor Ray
Date of Birth * 11-May-2002
Gender MALE
Enrollment No.
Nationality INDIAN
Present Address At+po- r.n.boulia,ps- manihari,dis- katihar pin code-854113
Mobile No. 7050932138
Email Address aniveshroy413@gmai.com

Course Details

Course Name /Code Advance Diploma in Computer Application (ADCA)
Course Duration 12 Months

Center Details

Center Code 91104139
Center Name Lord Buddha Computer Training Centre
Center Address Adampur
Decleration

I hereby declared that all the informations are correct and true to the best of my knowledge and belief.

Place: _______________

Date : _______________
Authorized Signatory