REGISTRATION FORM
Date: 2019-11-28 Reg. No.: 2026/93 Center Code: 2026 Name : Piyush Bhardwaj Father s Name : Sanjeev Bhardwaj Date Of Birth : 1999-05-07 Contact Address (Correspondence) : akash green moradabad Contact Address (Permanent) : akash green moradabad Contact Details : (R) (O) (M)  Name Of Course : Professional Diploma Software Covered :  Course Fee : 14000 Rs GST : 0 Rs Total Fee : 14000 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)