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Application Form | ||||
| Name of Candidate | Surendra Kumar |
91104101501 
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| Mother's Name | Rohila Devi | |||
| Father's Name | Shiv Ratan Prasad | |||
| Date of Birth * | 25-Jun-1988 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Darsha Nagar Salempur | |||
| Mobile No. | 7301130320 | |||
| Email Address | ksurendra@offerplant.com | |||
Course Details |
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| Course Name /Code | Certificate in Desktop Publishing (DTP) | |||
| Course Duration | 3 Months | |||
Center Details |
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| Center Code | 91104101 | |||
| Center Name | Sterliate Training Institute | |||
| Center Address | Adampur chowk | |||
| 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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