Application Form

Name of Candidate Shivam Kumar
911041570512

Student Photo Not Available
Mother's Name Mamta Devi
Father's Name Umesh Kumar Singh
Date of Birth * 06-Jul-2001
Gender MALE
Enrollment No.
Nationality INDIAN
Present Address Vill+Post-Sugma,Ward No-05,Block-Banma Itahri, District- Saharsa,State-Bihar,Pin Code-852129
Mobile No. 9334673101
Email Address shivamkumar94973@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