|
||||
Application Form | ||||
| Name of Candidate | Amit Kumar |
911021110180 
|
||
| Mother's Name | ||||
| Father's Name | Diwakar Thakur | |||
| Date of Birth * | 01-Jan-1970 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | raghopur, parbatta, bhagalpur, bihar, pin code= 853202 | |||
| Mobile No. | 1234567899 | |||
| Email Address | ||||
Course Details |
||||
| Course Name /Code | Diploma in Computer Application (DCA) | |||
| Course Duration | 6 Months | |||
Center Details |
||||
| Center Code | 91102111 | |||
| Center Name | Aditya Institute of Information Technology | |||
| Center Address | kharik | |||
| Decleration I hereby declared that all the informations are correct and true to the best of my knowledge and belief. |
||||
|
Place: _______________ Date : _______________ |
Authorized Signatory |
|||
|
| ||||