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Application Form | ||||
| Name of Candidate | Sushil Kumar |
911041021127 
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| Mother's Name | Dropadi Devi | |||
| Father's Name | Ishwar Mandal | |||
| Date of Birth * | 15-Feb-1966 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | s/o: iSHWAR mANDAL, SHANKARPUR, bHAGALPUR, BIHAR, 812004 | |||
| Mobile No. | 9006181496 | |||
| Email Address | ANUJCLG@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 | 91104102 | |||
| Center Name | Sterliate Training Institute | |||
| Center Address | Khanjarpur | |||
| 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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