REGISTRATION FORM
Date: 2019-10-22 Reg. No.: 2026/69 Center Code: 2026 Name : Mukul Kumar Father s Name : Bhagirath Singh Date Of Birth : 2000-05-08 Contact Address (Correspondence) : Vill. & Post-Makhdoompur Amroha Contact Address (Permanent) : Vill. & Post-Makhdoompur Amroha Contact Details : (R) (O) (M)  Name Of Course : Diploma Program Software Covered :  Course Fee : 12000 Rs GST : 0 Rs Total Fee : 12000 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)