Vicky Shrivas-920713010008

A division of
OM Computer Training Institute
Regd. Under Companies Act | Ministry of Corporates Affairs Govt of India
Regd Office : E-84, Gali No. 4, New Ashok Nagar, Near Dashmesh Public School, Vasundhra Enclave, New Delhi, 110096
Application Form

Student Details

Name of Candidate : Vicky Shrivas
Reg. No. 920713010008

Student Photo Not Available
Mother's Name : Suneeta
Father's Name : Dinesh Shrivas
Date of Birth * : 26-Mar-2004
Gender : MALE
Nationality : INDIAN
Present Address : Gali No.3, Railway Colony Delhi -92
Mobile No. : 9625566151
Email Address : vickyshrivas545@gmail.com

Course Details

Course Name /Code : Certificate in Computer Application (CCA)
Course Duration : 3 Months

Attached Document

Identity Proof : Sorry No Attachment
Educational Certificate : Sorry No Attachment
Decleration

I hereby declared that all the informations are correct and true to the best of my knowledge and belief.

Place: , East Delhi
Date : 24-May-2023

Signature of Student

Center Details

Center Code : 92071301

Verified By
Center Name : OM Computer Training Institute
Center Address : Fazalpur, Mandawali, Delhi-92, (East Delhi)
ID Proof
Educational Proof