|
||||
Application Form | ||||
| Name of Candidate | Pultun Kumar Das |
911041011685 
|
||
| Mother's Name | Lakho Devi | |||
| Father's Name | Lobhan Harizan | |||
| Date of Birth * | 20-Jul-1995 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | RAJPUR, sabour, Bhagalpur, Bihar 813210 | |||
| Mobile No. | 8873824616 | |||
| Email Address | ||||
Course Details |
||||
| Course Name /Code | Diploma in Computer Application (DCA) | |||
| Course Duration | 6 Months | |||
Center Details |
||||
| 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. |
||||
|
Place: _______________ Date : _______________ |
Authorized Signatory |
|||
|
| ||||