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1. Category: Talent Pool/General

2. Last Exam Name: PEC/ISC/SSC/HSC flffrite only the last

passed exam)

3" Last Exam Year: Exam year of PEC/JSC/SSC/HSC (Write

only one)
4. Board: ln case of PEC write 'Primary'; ln case of board exam
write Name of Board
5. Registration No. (Last Exam): Student's Registration Number of last
exam (PECiJSC/SSC/HSC; Write only one)

6. Roll No (Last Exam): Student's Roll Number of last exam

(PEC/JSC/SSC/HSC; Write only one)

7. Student Name

8. Class: Upto higher secondary write: 6/7/8/9110111112;

Above Higher Secondary write: 1st yearl2nd year/ 3rd yearl4lh

year/Sth year

L Birth Reg. No.: Student's Birth Reg. No

10. Father Name

11. Father NID

12. Mother Name

13 Mother NID

14. Guardian Name (if applicable): Name of Guardian if

necessary

15. Guardian NID (lf applicable): NID of Guardian if necessary

16. Student's Permanent Address

17. Division: Student's Permanent Dlvision

18. District: Student's Permanent District

1 9. Upazila/Thana: Student's Permanent Upazila/Thana

20. Mobile No: Student's Contact No

21. Current lnstitution Name: Name of institute where the student

is studying at present

22. Current lnst. EllN: Provide EllN of Institute, lf any

23, Current lnst. Mobile

24. Passed lnstitution Name: Name of institute from where the

student has passed last Board/PEC Exam

25. Passed lnst. EllN: Provide EllN of lnstitute, lf any

a
26. Student's Account Number: Bank Account Number of the
student

27.Bank Name: Name ofthe Bank

28. Bank Branch: Bank Branch Name & Routing no