Application Form

Name of Candidate Gautam Kumar
911045621058

Student Photo Not Available
Mother's Name Sushila Devi
Father's Name Suresh Ram
Date of Birth * 16-Feb-1996
Gender MALE
Enrollment No.
Nationality INDIAN
Present Address VILL MANPUR PO ALIGANJ PS CHANDRADEEP DIST JAMUI PIN CODE 811301
Mobile No. 7979764262
Email Address gautam6448@gmail.com

Course Details

Course Name /Code Certificate In Computer Typing (CT)
Course Duration 6 Months

Center Details

Center Code 91104562
Center Name ICT COMPUTER EDUCATION
Center Address Aliganj
Decleration

I hereby declared that all the informations are correct and true to the best of my knowledge and belief.

Place: _______________

Date : _______________
Authorized Signatory