REGISTRATION FORM
Date: 2019-07-29 Reg. No.: 2026/10 Center Code: 2026 Name : divyanshu prabhakar Father s Name : rajkumar sharma prabhakar Date Of Birth : 2001-05-07 Contact Address (Correspondence) : vill.bairampur post.kurirawana moradabad Contact Address (Permanent) : vill.bairampur post.kurirawana moradabad Contact Details : (R) (O) (M)  Name Of Course : Certificate Program Software Covered :  Course Fee : 5000 Rs GST : 0 Rs Total Fee : 5000 Rs I have read the terms & conditions printed overleaf, Understood the same and here by confirm having accepted the same for joining the course For : MORADABAD UTTAR PRADESH         Student s Signature Authorised Center (Seal & Signature)