STUDENT REGISTRATION FORM

DIGITAL INDIA COMPUTER ACADEMY

STUDENT ENROLLMENT FORM

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1. CANDIDATE NAME

2. FATHER'S / HUSBAND NAME

3. MOTHER'S NAME

4. DATE OF BIRTH

5. GENDER-- Select --MaleFemaleOther

6. RELIGION

7. CATEGORY (SC/ST/OBC/GEN)

8. EDUCATION

9. MOBILE NUMBER

10. AADHAR NO.

11. ADDRESS

12. SELECT COURSE -- Choose Course -- BCC ( Basic Computer Course ) CCA ( Certificate in Computer Application ) CCC (Course on Computer Concepts) DCA ( Diploma in Computer Application ) ADCA ( Advance Diploma in Computer Application ) Tally Prime DTP ( Desktop Publishing ) Typing

Candidate Signature

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Manager Signature & Stamp