|
||||
Application Form | ||||
| Name of Candidate | Sourabh Kumar |
911029041142 
|
||
| Mother's Name | Tila Devi | |||
| Father's Name | Arjun Mandal | |||
| Date of Birth * | 16-Mar-2005 | |||
| Gender | MALE | |||
| Enrollment No. | Kha/26/06/cca226/07 | |||
| Nationality | INDIAN | |||
| Present Address | Muktapur, nadiyama, goradih, bhagalpur, bihar, pin-813205 | |||
| Mobile No. | 9263311705 | |||
| Email Address | punajsmith@gmail.com | |||
Course Details |
||||
| Course Name /Code | Certificate In Computer Application (CCA) | |||
| Course Duration | 3 Months | |||
Center Details |
||||
| Center Code | 91102904 | |||
| Center Name | Computer Training Institute | |||
| Center Address | Kahalgaon | |||
| Decleration I hereby declared that all the informations are correct and true to the best of my knowledge and belief. |
||||
|
Place: _______________ Date : _______________ |
Authorized Signatory |
|||
|
| ||||