Shivam-760703010005

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 : Shivam
Reg. No. 760703010005

Student Photo Not Available
Mother's Name : Bunti
Father's Name : Ramkishor
Date of Birth * : 18-Mar-2007
Gender : MALE
Nationality : INDIAN
Present Address : Dairy No.6, Madanpur Khadar, sarita vihar delhi- 110076
Mobile No. : 7042417203
Email Address : kumarshivam59072@gmail.com

Course Details

Course Name /Code : Advance Diploma in Computer Application (ADCA)
Course Duration : 12 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: , South Delhi
Date : 11-Jun-2022

Signature of Student

Center Details

Center Code : 76070301

Verified By
Center Name : OM Computer Training Institute
Center Address : Madanpur Khadar Vill. Sarita Vihar, Delhi-110076, (South Delhi)
ID Proof
Educational Proof