University of Rajshahi

Convocation 2012

Registration Form

Registration Fee Receipt No :

Paste
Passport size
Photo

_______________________

Name of Applicant
(According to SSC)

In Bangla : _______________________________
In English : _______________________________
Father's name : _______________________________

Permanent Address

Village/Ward
PS
Post Code
PO

Present Address

Village/Ward
PS
Post Code
PO

Year of Exam

:
:
:
:
District :

_______________________________
_______________________________
_______________________________
_______________________________
_______________________________

:
:
:
:
District :
Cell Phone :
Email :

_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________

Name of Examination/Award :
Year of Exam :
Subject :
Held in :
Roll No :

_______________________________
_______________________________
_______________________________
_______________________________
_______________________________

Name of Hall/College

: _________________________________________________

_______________________________
Signature of Participant