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KAPIL KUMAR GOYAL

GOPAL MACHINARY STORE


JEWAR
NOIDA
Uttar Pradesh-203135

Phone 5738-272346
Mobile 9456274128

goel.elephant.kapil@gmail.com

Gender : male
Date of birth : 1987-07-01
Caste / Tribe : general
Physical Handicap : no
Center for Examination : New Delhi
Highest Qualification : Graduate
Selected Course : Diploma In Editing / Certificate In Video Editing
Demand Draft No. : 964918
Amount : Rs. 2000
Place of Bank DD drawn on : PUNE MAIN
Date of DD : 2010-05-12
Issuing Branch Name : HIRA BAGH COLONY AGARA
Name of Bank DD drawn on : The State Bank of India

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Declaration and Endorsement


06/06/2010

Declaration

The information provided in online application is correct to the best of my knowledge and belief.
I understand that the decision of the Director is final in regard to selection for admission and
assignment to a particular course of study.

Place :
Date :

Signature of an Applicant
Note: Please do not attach any certificate in original or in photocopy.

Endorsement of the Father / Guardian


I have acquainted myself with and agree to the course and regulations of the Film and Television
Institute of India, Pune and fully endorse the application of my ward.

Place :
Date :

Signature of Father/Guardian

Center/Course : New Delhi/Diploma In Editing / Certificate In Video Editing

Copyright © Film and Television Institute of India, Pune.

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