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.
FB0003/00030
Name of Candidate
gautam kumar
1721081204jfif
Mother's Name
nilam ray
Father's Name
yogendra paswan
Date of Birth
05-02-1997
Mobile No. :
8409591230
Gender :
MALE
Nationality :
Address
vill- anaipur, po- belar, belar, na
wada, bihar - 805130
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