K B A L Educational

673 -A, SECOND FLOOR ,GALI NO. 7 , GOVINDPURI, KALKAJI NEW DELHI -110019, INDIA
S. M. COLLEGE ROAD, NEAR KALI MANDIR, CHHOTI KHANJARPUR, BHAGALPUR, BIHAR -812001

7070151596 | enquiry@kbaleducation.org.in | https://kbaleducation.org.in/apprise/

Application Form
Registration No.
KB1109-CA0
2
Name of Candidate
Avinash Kumar
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Mother's Name
Malti Devi
Father's Name
Sambhu Sahni
Date of Birth
20-02-2001
Mobile No. :
9262634210
Gender :
MALE
Nationality :
INDIAN
Address
Email Address
avinashhenry210@gmail.com
Date of Admission
01-01-1970
Pincode. :
Course Details
Course Name
Diploma in Computer Application
Course Code
DCA
Course Duration
6 Months
Center Details
Center Name & Code
SMART COMPUTER ACADEMY (C009)
Center Address
Kahalgaon
Decleration

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

Place: _______________

Date : 19/Jan/2024 04:05 PM

Authorized Signatory