Application Form

Name of Candidate Bande Purushottam
911078460062

Student Photo Not Available
Mother's Name Kanchan Kumari
Father's Name Ajay Kumar
Date of Birth * 10-Jun-1997
Gender MALE
Enrollment No.
Nationality INDIAN
Present Address SAHARSA
Mobile No. 8877668018
Email Address rajamr256@gmail.com

Course Details

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

Center Details

Center Code 91107846
Center Name Tejas Computer Institute
Center Address Parwiniya ,Sonbarsa Kachari Road
Decleration

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

Place: _______________

Date : _______________
Authorized Signatory