info@icaedu.in| https://icaedu.co.in/
|
||||
Application Form | ||||
| Name of Candidate | Shivendra Kaushik |
911004013302 
|
||
| Mother's Name | Santoshi Rao | |||
| Father's Name | Ramni Kant Mani Kaushik | |||
| Date of Birth * | 21-Aug-2007 | |||
| Gender | MALE | |||
| Nationality | INDIAN | |||
| Present Address | Dault Ganj Adda. No. 5 | |||
| Mobile No. | 9905375093 | |||
| Email Address | ||||
Course Details |
||||
| Course Name /Code | Advance Diploma in Computer Application (ADCA) | |||
| Course Duration | 12 Months | |||
Center Details |
||||
| 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. |
||||
|
Place: _______________ Date : _______________ |
 Authorized Signatory |
|||