Application Form

Name of Candidate Shivam Kumar
911041051226

Student Photo Not Available
Mother's Name Chandni Devi
Father's Name Niranjan Mandal
Date of Birth * 24-May-2005
Gender MALE
Enrollment No.
Nationality INDIAN
Present Address AT+P.O KAPSOUNA P.S SHAHKUND DIST BHAGALPUR PIN 813108
Mobile No. 8434052381
Email Address SHIVAMKU628868@GMAIL.COM

Course Details

Course Name /Code Certificate In Computer Typing (CT)
Course Duration 6 Months

Center Details

Center Code 91104105
Center Name Lord Buddha Computer Institute
Center Address Sultanganj
Decleration

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

Place: _______________

Date : _______________
Authorized Signatory