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Application Form | ||||
| Name of Candidate | Shyam Sundar Kumar Gupta |
911054060023 
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| Mother's Name | Shiv Kumari Devi | |||
| Father's Name | Surendra Kumar | |||
| Date of Birth * | 14-Sep-1998 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | ITI JAIPRAKASH NAGAR BETTIAH 845438 | |||
| Mobile No. | 8002142268 | |||
| Email Address | anands.foundation@gmail.com | |||
Course Details |
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| Course Name /Code | Advance Diploma in Computer Application (ADCA) | |||
| Course Duration | 12 Months | |||
Center Details |
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| Center Code | 91105406 | |||
| Center Name | Sterlite Training Institute | |||
| Center Address | Prabhat Colony | |||
| 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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