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| Full Name | Md. Imtiaz Ibn Seraj |
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| SSC Batch | 2000 |
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| Father's Name | Md. Serajul Islam |
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| Present Address | Al Ameen Bhaban,411/4A, Road-4, Moubag, Shimultoli, Gazipur |
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| Blood Group | A+ |
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| Occupational Address | Manager Secutrity, BOF, Gazipur-1703 |
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| Permanent Address | Vill: Ahmedpur, P.O.- Ghoramara, P.S.- Boalia, Dist.- Rajshahi. |
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| Mobile Number | 01769007081 |
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| Payment Information | |
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| Date of Birth | 26/10/1984 |
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| Member Type | General Member |
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| National ID No. | 4614530816 |
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| Present Occupation | Defence Officer (Army) (Major) |
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| Payment Option | bKash |
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| Sender Mobile Number | 01769007081 |
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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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