REGISTRATION FORM
Date: 2020-03-17 Reg. No.: 2026/156 Center Code: 2026 Name : Pankaj kumar barnval Father s Name : Birendra prasad Date Of Birth : 1997-05-10 Contact Address (Correspondence) : vill- guthani post- guthani dist- siwan state- bihar Contact Address (Permanent) :  vill- guthani post- guthani dist- siwan state- bihar Contact Details : (R) (O) (M)  Name Of Course : Certificate course in Civil CAD Software Covered :  Course Fee : 1000 Rs GST : 0 Rs Total Fee : 1000 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)