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| Full Name | MR MOHAMMAD SHAHJAHAN MIA |
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| SSC Batch | 1992 |
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| Father's Name | MOHAMMAD MOSLEM UDDIN |
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| Present Address | HOUSE-C/112, WARD-6, KUMRAILM DHAMRAI, DHAMRAI, DHAKA-1350 |
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| Blood Group | B+ |
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| Occupational Address | CHUTI GROUP, MILLENNIUM CASTLE FLAT-4A&7BM, HOUSE-47, ROAD-27, BLOCK-A, BANANI, DHAKA-1213 |
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| Permanent Address | HOUSE-C/112, WARD-6, KUMRAILM DHAMRAI, DHAMRAI, DHAKA-1350 |
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| Mobile Number | 01819888973 |
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| Payment Information | |
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| Date of Birth | 01/05/1977 |
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| Member Type | Lifetime Member |
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| National ID No. | 1904471131 |
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| Present Occupation | SERVICE |
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| Membership fee (Lifetime) | 5000 |
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| Payment Option | bKash |
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| Sender Mobile Number | 01819888973 |
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| Approved? (Admin-only) | |
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| Agreement |  I agree to the privacy policy.
I hereby declare that the information above provided by me are true and correct to the best of my knowledge. I hereby sign this form to register myself to be member at the Gazipur Cantonment Board High School Alumni Association. |
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