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Application Form | ||||
| Name of Candidate | Jalees Shasan Nayeem |
911041260191 
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| Mother's Name | Shirin | |||
| Father's Name | Ali Reza Nayeem | |||
| Date of Birth * | 03-Nov-2003 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Abdul mojib lane bhikanpur gumti no 3 south of madina masjid roshan house bhagalpur bihar 812001 | |||
| Mobile No. | 8579974482 | |||
| Email Address | shadanjalees39@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 | 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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