|
||||
Application Form | ||||
| Name of Candidate | Mayank Shaw |
911041393002 
|
||
| Mother's Name | Sunita Shaw | |||
| Father's Name | Om Prakash Shaw | |||
| Date of Birth * | 31-Jul-2002 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Judge court road, near W.B board of secondary education paschim Medinipur, West Bengal, 721101 | |||
| Mobile No. | 9064431052 | |||
| Email Address | ||||
Course Details |
||||
| Course Name /Code | Advance Diploma in Computer Application (ADCA) | |||
| Course Duration | 12 Months | |||
Center Details |
||||
| Center Code | 91104139 | |||
| Center Name | Lord Buddha Computer Training Centre | |||
| Center Address | Adampur | |||
| Decleration I hereby declared that all the informations are correct and true to the best of my knowledge and belief. |
||||
|
Place: _______________ Date : _______________ |
Authorized Signatory |
|||
|
| ||||