|
||||
Application Form | ||||
| Name of Candidate | Shivam Kumar |
911041391142 
|
||
| Mother's Name | Shila Devi | |||
| Father's Name | Pankaj Pd Singh | |||
| Date of Birth * | 22-Feb-1997 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Darjikitta lashkari darzikta Banka Bihar pin code-813105 | |||
| Mobile No. | 7631220204 | |||
| Email Address | shivamkumar22297@gmail.com | |||
Course Details |
||||
| Course Name /Code | Diploma in Computer Application (DCA) | |||
| Course Duration | 6 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 |
|||
|
| ||||