REGISTRATION FORM
Date: 2021-04-17 Reg. No.: 2026/245 Center Code: 2026 Name : Himani Gupta Father s Name : Neeraj Kumar Date Of Birth : 1994-09-21 Contact Address (Correspondence) : Near 23 P.A.C Nosegay School Campus Kanth Road. Contact Address (Permanent) : Near 23 P.A.C Nosegay School Campus Kanth Road. Contact Details : (R) (O) (M)  Name Of Course : Diploma Program Software Covered :  Course Fee : 16000 Rs GST : 0 Rs Total Fee : 16000 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)