REGISTRATION FORM
Date: 2025-07-25 Reg. No.: 2026/653 Center Code: 2026 Name : Harsh Kumar Father s Name : Virendra Kumar Date Of Birth : 2007-07-08 Contact Address (Correspondence) : Sultanpur Khas Urf Bhagtawala Po-udaypur Thana Rehar Tehsil Dhampur Distt-bijnor Contact Address (Permanent) : Sultanpur Khas Urf Bhagtawala Po-udaypur Thana Rehar Tehsil Dhampur Distt-bijnor Contact Details : (R) (O) (M)  Name Of Course : Certificate Course In Electrical IC Software Covered : Electrical AutoCAD Course Fee : 4999 Rs GST : 0 Rs Total Fee : 4999 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)