|
||||
Application Form | ||||
| Name of Candidate | Satyam Bhagat |
911041520282 
|
||
| Mother's Name | Asha Devi | |||
| Father's Name | Pradip Kumar Bhagat | |||
| Date of Birth * | 05-Jan-2007 | |||
| Gender | MALE | |||
| Enrollment No. | ||||
| Nationality | INDIAN | |||
| Present Address | shadev bhagat lane, goldar patti , nathnagar, bhagalpur, bihar, 812006 | |||
| Mobile No. | 7370037036 | |||
| Email Address | satyambhagat9706@gmail.com | |||
Course Details |
||||
| Course Name /Code | Advance Diploma in Computer Application (ADCA) | |||
| Course Duration | 12 Months | |||
Center Details |
||||
| Center Code | 91104152 | |||
| Center Name | Evergreen Computer Training Institute | |||
| Center Address | Nathnagar | |||
| Decleration I hereby declared that all the informations are correct and true to the best of my knowledge and belief. |
||||
|
Place: _______________ Date : _______________ |
Authorized Signatory |
|||
|
| ||||