REGISTRATION FORM
Date: 2019-09-06 Reg. No.: 2026/29 Center Code: 2026 Name : Chandra Mohan Singh Father s Name : Mr. Ravi Prakash Date Of Birth : 1999-09-28 Contact Address (Correspondence) : Samrat Ashok Nagar near CL Gupta Bagh Moradabad Contact Address (Permanent) : Samrat Ashok Nagar near CL Gupta Bagh Moradabad Contact Details : (R) (O) (M)  Name Of Course : Advance Diploma Software Covered :  Course Fee : 51000 Rs GST : 0 Rs Total Fee : 51000 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)