Apprise Institute of Computing
Hari Mohan Gali, Salempur Chapra 841301
Kumar Bhwan, Umanagr Chapra 841301
9431426600 | ask@offerplant.com | https://apprise.morg.in/apprise/
Application Form
Registration No.
FB0003/00022
Name of Candidate
BADAL RAVIDAS
BADAL PHOTO.JPG
Mother's Name
KUNTI DEVI
Father's Name
MOHAN RAVIDAS
Date of Birth
30-11--000
1
Mobile No. :
8539068990
Gender :
MALE
Nationality :
Address
VILL+PO- DUMRAWAN, PS - PAKRI BARAW
AN, NAWADA, BIHAR- 805124
Pincode. :
Date of Admission
01-01-1970
Email Address
Course Details
Course Name
Advance Diploma in Computer Applica
tion
Course Code
ADCA
Course Duration
12 Months
Center Details
Center Name
Quantum Computer Academy
Center Code
FB0003
Center Address
Pakri Barawan, Adilabad
Decleration

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

Place: _______________

Date : 12/Oct/2023 01:39 AM

Authorized Signatory