|
||||
Application Form | ||||
| Name of Candidate | Goutam Kumar |
911041570115 
|
||
| Mother's Name | Mala Devi | |||
| Father's Name | Ramrekh Yadav | |||
| Date of Birth * | 14-Oct-1992 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Near R.H.M.T.B HIGH SCHOOL, KATHALBARI, BARARI BHAGALPUR BIHAR - 812003 | |||
| Mobile No. | 7766909017 | |||
| Email Address | goutam.smpl@gmail.com | |||
Course Details |
||||
| Course Name /Code | Certificate In Computer Typing (CT) | |||
| Course Duration | 6 Months | |||
Center Details |
||||
| Center Code | 91104157 | |||
| Center Name | Vivek Computer Classes | |||
| Center Address | Barari,Near ITI College | |||
| Decleration I hereby declared that all the informations are correct and true to the best of my knowledge and belief. |
||||
|
Place: _______________ Date : _______________ |
Authorized Signatory |
|||
|
| ||||