Ashtarudra Institute Of Computer Education

www. ashtarudra.weebly.com Email: ashtarudra26@gamil.com

Phone:+91 894 8981 234
Goshaiganj Road Bhiti Bazar
Ambedkar Nager

Registration Form Paste your

Morning Afternoon Evening
Serial No: _______________ photograph
(Tick the appropriate box)

Name
(Block Letter)

Name Of
Guardian
(Father/Husband/Guardians Name in Block Letter)

Date Of Birth : _____/____/_______ Gender : Male Female

Martal Status : Married Unmarried Nationality : _______________
Address : ____________________ Post : _______________

District : _____________________________________________________

Contact : Cell
E-mail _____________________________
ACADEMIC QUALIFICATION

Degree Board/University Year

10th
10th +2
BA/Bsc/B.Com

For Office Use Only

Rool No : ______________________ Registration No. : _________________

Diploma In : ______________________ Date : ____/_____/______

Admission Free : ______________________ signature