Application Form

Name of Candidate Shivam Anand
911078460097

Student Photo Not Available
Mother's Name Mina Devi
Father's Name Akhilesh Mishra
Date of Birth * 10-Feb-2002
Gender MALE
Enrollment No.
Nationality INDIAN
Present Address aT-GOPALPUR WARD NO.04,SAHARSA
Mobile No. 7367066457
Email Address sm1843141@gmail.com

Course Details

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