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Application Form | ||||
| Name of Candidate | Sujal Shaw |
911063090386 
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| Mother's Name | Rekha Debi | |||
| Father's Name | Rajendra Shaw | |||
| Date of Birth * | 30-Jan-2007 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | Vill- Bhareti Wazirganj, Po+Ps- Wazirganj, Dist-Gaya (Bihar)805131 | |||
| Mobile No. | 6291506997 | |||
| Email Address | 09sujal09@gmail.com | |||
Course Details |
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| Course Name /Code | Certificate In Computer Typing (CT) | |||
| Course Duration | 6 Months | |||
Center Details |
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| Center Code | 91106309 | |||
| Center Name | A Global Computer Academy | |||
| Center Address | Wazirganj | |||
| 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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