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Application Form | ||||
| Name of Candidate | Bikram Rajak |
911020350047 
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| Mother's Name | Shakuna Devi | |||
| Father's Name | Bhudeo Rajak | |||
| Date of Birth * | 05-Dec-1999 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Bikram Rajak, S O - Bhudeo Rajak, At - Mohadipur, P.O. - Mohdipur, P.S. - Jagdishpur, Dist. - Bhagalpur, State - Bihar, 813105 | |||
| Mobile No. | 6299591205 | |||
| Email Address | bikram813105@gmail.com | |||
Course Details |
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| Course Name /Code | Diploma in Computer Application (DCA) | |||
| Course Duration | 6 Months | |||
Center Details |
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| Center Code | 91102035 | |||
| Center Name | Evergreen Computer Institute | |||
| Center Address | Amarpur | |||
| Decleration I hereby declared that all the informations are correct and true to the best of my knowledge and belief. |
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Place: _______________ Date : _______________ |
Authorized Signatory |
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