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| Full Name | Md. Delwar Imtiaz-Ul-Haque |
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| SSC Batch | 2000 |
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| Father's Name | Md. Mozammel Haque |
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| Present Address | 447/48, Shimultoi Housing, BOF, Gazipur. |
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| Blood Group | O+ |
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| Occupational Address | Centro Tex Ltd. BGMEA Complex, House-7/7A, Sector-17, Block-H-1, Uttara, Dhaka-1230 |
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| Permanent Address | Vill: Khairipara, P.S.- Kotowali, P.O.-Ghughudonga, Dist- Dinajpur |
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| Mobile Number | 01916574074 |
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| Payment Information | |
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| Date of Birth | 26/12/1985 |
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| Member Type | Lifetime Member |
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| National ID No. | 3353098232009 |
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| Present Occupation | Marchendiser, Centro Tex Ltd. |
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| Membership fee (Lifetime) | 5000 |
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| Payment Option | bKash |
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| Sender Mobile Number | 01916574074 |
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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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