REGISTRATION FORM
Date: 2025-03-05 Reg. No.: 2026/668 Center Code: 2026 Name : Vikas Pal Father s Name : Mr. Bablu Pal Date Of Birth : 2006-03-03 Contact Address (Correspondence) : Fatehganj(west) Bareilly Post Bhitaura, Lodhi Nagar,243501 Contact Address (Permanent) : Fatehganj(west) Bareilly Post Bhitaura, Lodhi Nagar,243501 Contact Details : (R) (O) (M)  Name Of Course : Certificate Course In Electronics Software Covered :  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)