REGISTRATION FORM
Date: 2020-01-16 Reg. No.: 2026/100 Center Code: 2026
Name : Madhav Dixit
Father s Name : Dr. Keshav Sharma
Date Of Birth : 2003-03-10
Contact Address
(Correspondence)		 : Moradabad
Contact Address
(Permanent)		 : Moradabad
Contact Details : (R) (O) (M) 
Name Of Course : Professional Diploma
Software Covered : 
Course Fee : 60000 Rs
GST : 0 Rs
Total Fee : 60000 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)