REGISTRATION FORM
Date: 2019-09-23 Reg. No.: 2026/46 Center Code: 2026 Name : Imran Father s Name : Ashraf Ali Date Of Birth : 1991-06-25 Contact Address (Correspondence) : Thana- Ganj, Rampur Contact Address (Permanent) : Thana- Ganj, Rampur Contact Details : (R) (O) (M)  Name Of Course : Diploma Program Software Covered :  Course Fee : 10000 Rs GST : 0 Rs Total Fee : 10000 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)