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| Full Name | Rukaiya Karim Eva |
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| SSC Batch | 2012 |
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| Father's Name | Md. Rejaul Karim |
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| Present Address | 78, Sheltech Nishowrga, South Chatar, Shaheed Zaman Sarok, BOF, Ward-24, Gazipur City Gazipur. |
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| Blood Group | O+ |
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| Permanent Address | Vill: Changtia, P.O.- Dharoil Hat, P.S.- Ullapara, Dist-Sirajgonj. |
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| Birth Certificate No. | 19973333098000613 |
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| Mobile Number | 01767723200 |
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| Payment Information | |
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| Date of Birth | 09/05/1997 |
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| Member Type | General Member |
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| National ID No. | 3755353806 |
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| Present Occupation | Unemployed |
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| Payment Option | bKash |
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| Sender Mobile Number | 01767723200 |
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| Membership fee (General) | 500 |
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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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