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Application Form | ||||
| Name of Candidate | Rishu Kumar |
911041260189 
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| Mother's Name | Sarita Devi | |||
| Father's Name | Amit Kumar | |||
| Date of Birth * | 01-Jan-2008 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Lodipur bhaghpur | |||
| Mobile No. | 9113789854 | |||
| Email Address | rahulclg6035@gmail.com | |||
Course Details |
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| Course Name /Code | AC Technician (ACT ) | |||
| Course Duration | 4 Months | |||
Center Details |
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| Center Code | 91104126 | |||
| Center Name | Sterliate Training Institute | |||
| Center Address | Laluchak | |||
| 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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