Imran -909170100789

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 : Imran
Reg. No. 909170100789

Student Photo Not Available
Mother's Name : Shabana Begum
Father's Name : Md Thair
Date of Birth * : 14-Feb-2001
Gender : MALE
Nationality : INDIAN
Present Address : MATA COLONY BAGHPAT, BAGHPAT, UTTAR PRADESH 250609
Mobile No. : 9012189110
Email Address : Rangrezguddu2@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: , Bagpat
Date : 05-Jun-2023

Signature of Student

Center Details

Center Code : 90917010

Verified By
Center Name : A.S. Computer Center
Center Address : Mohalla Mugalpura, Near Sahil CSC Center, Baghpat, (Bagpat)
ID Proof
Educational Proof