Application Form 

Radiance Institute of Computer Applications

Radiance Institute Of Computer Applications (RICA)

173/35, 2^nd Floor, Dr. B. N. Verma Road, Aminabad Lucknow

Course Name: Duration:

Student’s Name (in capital letters):

Father’s Name (in capital letters):

Date of Birth: Age

Institution (if any)

Mailing Address:                                                         Permanent Address:

Ph.:                                                                                 Ph.:

E-mail Address:

Other Qualifications: ………………………………………………………………………………..

Employed Unemployed

Note: Attach one passport size photograph and photocopies of Mark Sheets/Certificates in
supporting of academic & other qualifications.

                                                                        Signature of student

Signature of Father/ Guardian Date:………………

Mr./Ms/Mrs.………………………………..S/o / D/o W/o………………………….… is admitted in course of ………………….…………….…since………………with monthly fee Rs. ……………… and allotted: Enrolled No.:……………… …… Batch Timing:…………………….

Signature

Incharge (RICA)