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REGISTRATION FORM: 6 MONTH TRAINING 2010

Personal Details:

Name

Father Name

Nationality

Gender

Mailing Address

Email ID

Alternate Email ID

Mobile No.

Home Ph. No.

Educational Details:

Working Status

Branch

Year

College Name

College State

College City

Training Details:

Training Location

Course to be joined

Batch Date

Duration

Fooding & Lodging

Paying Guest Facility is available for candidatePaying Guest Facility is available for candidate

Bank Details:

Multiple Candidate

Check if your draft is used for more than one candidate or for more than one course

Bank Name

D D Amount

Draft Amount >=2000

Demand Draft No.

Draft Issue date

Aug September 2010 Oct

Sun

Mon

Tue

Wed

Thu

Fri

Sat

Declaration of student:

I here by declare that all the above information are true to the best of my knowledge.