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.
KB1109-501
S
Name of Candidate
Jeevan Kumar
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Mother's Name
Father's Name
Shravendra Thakur
Date of Birth
12-03-2001
Mobile No. :
6206958706
Gender :
MALE
Nationality :
INDIAN
Address
JAGANNATHPUR TOLA FARDA,MUNGER
Email Address
jeevankkrmr@gmail.com
Date of Admission
15-12-2023
Pincode. :
Course Details
Course Name
Advance Diploma in Computer Applica
tion
Course Code
ADCA
Course Duration
12 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 : 30/Jan/2025 05:26 PM

Authorized Signatory