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Application Form | ||||
Name of Candidate | Rupesh Kumar Khairwar |
911004014003 |
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Mother's Name | Shila Devi | |||
Father's Name | Sohan Prasad Khairwar | |||
Date of Birth * | 26-Aug-2006 | |||
Gender | MALE | |||
Nationality | INDIAN | |||
Present Address | Revelganj, Saran | |||
Mobile No. | 9931982964 | |||
Email Address | ||||
Course Details |
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Course Name /Code | Advance Diploma in Information Technology (ADIT) | |||
Course Duration | 12 Months | |||
Center Details |
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Center Code | 91100401 | |||
Center Name | Quantum Computer Academy | |||
Center Address | Salempur, Chapra | |||
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 |