Application Form

Name of Candidate Basant Kumar
911041140308

Student Photo Not Available
Mother's Name Jhuma Devi
Father's Name Lukki Mandal
Date of Birth * 28-Feb-2002
Gender MALE
Enrollment No.
Nationality INDIAN
Present Address vill- ziyauddinpur chauka, dps school, bhagalpur, sabour, 813210
Mobile No. 7631743953
Email Address basantjpc@gmail.com

Course Details

Course Name /Code Advance Diploma in Computer Application (ADCA)
Course Duration 12 Months

Center Details

Center Code 91104114
Center Name CTI
Center Address NH-80, Opp.Tata Motors, Sabour
Decleration

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

Place: _______________

Date : _______________
Authorized Signatory