INFORMATION CHECK LIST

BASIC INFORMATION

Full Name (In English) -------------------------------------------------------------

Full Name (In Bengali) –------------------------------------------------------------

(ISSB result card will contain this name)

Email Address------------------------------------------------------------------------

Face book ID--------------------------------------------------------------------------

National ID (If any) -------------------------------------------------------------- ---

Permanent Address------------------------------------------------------------------

Present Address----------------------------------------------------------------------

Mobile No------------------------------------------------------------------------- ----

Date of Birth*------------------------------------------------------------------------

Place of Birth-------------------------------------------------------------------------

Birth District-------------------------------------------------------------- -----------

Photo (300 X 300 pixels (Width X Height). The file size cannot be more than 100 KB. )

(You have to upload a recently taken and clear photo)

NATIONALITY

Nationality---------------------------------------------------------------------------

Are you Bangladeshi by Birth? -----------------------------------------------------

Father's nationality------------------------------------------------------------------

Father's nationality Type (If Bangladeshi) (By Birth /Immigrant /Migrant)

-----------------------------------------

Mother's nationality-----------------------------------------------------------------
Mother's nationality Type (If Bangladeshi) (By Birth /Immigrant /Migrant)
---------------------

If your parent's Nationality is not Bangladeshi by birth , then--------

Your entry date (In Bangladesh) ------------------------

From which country did you come? ---------------------

Your Religion----------------------------------------------

Sect---------------------------------------------------------

EDUCATION
SSC/equivalent, HSC/equivalent:

Exam Branch Language College / Board Passing Division

Name (Science, Medium Institute Year /Class
Commerce (EIIN and /GPA
etc name)
SSC/equivalent
HSC/equivalent
EIIN will help you to easily find your HSC/equivalent College / Institute form the list
If you are going to appear for HSC/equivalent in the current year

Your roll number ------------------------

Registration No--------------------------

Board--------------------------------------

Higher Education: (If applicable to you) - You are to include only one
which fulfills your application eligibility)

Level of education Branch Language University/College / Passing Division

(Bachelor/Masters /subject etc Medium Institute etc Year /Class
etc) Specifically /GPA
(Example:
MBBS,EEE
etc)

Have you ever been expelled from any educational institution? If so ---

Year of incident--------------------------------

Educational Institute Name----------------------------------------

Reason------------------------------------------------------------------
Do you have any break of study? If yes, provide following details:

Starting year of the break of study------------------------------

End year of the break of study? ----------------------------------

Reason-----------------------------------------------------------------

Last Examination you appeared before break ----------------

GAMES/HOBBY

Games and Extracurricular Activities : (Maximum 10)

Games/ Institute (if related) Award/achievement (if

Extracurricular any)
Activities

Hobby: (Max 3)

Games/ Institute (if related) Award/achievement (if

Extracurricular any)
Activities

ISSB INFORMATION

Information about previous appearance in ISSB (If appeared)-

(You must include all if appeared number of times) -----------

Service---------------------------Roll No. --------------------------

Month-----------------------Year-------------------------

Result---------------------------

Preparation for ISSB (if any)

Name of Institution------------------------------- Address --------------------

------------------------------------------------------Duration -----------------------

Learned subjects/ items---------------------------------------------------

LEGAL ISSUES AND PROFESSION

Have you ever been arrested, indicted or summoned into court, or convicted,
fined or imprisoned for the violation of any law?

Yes /No-----------------------------------

Had you been arrested by police at anytime? Yes /No------

If yes to any, then mention case details -------------------------------------------

--------------------------------------

Your present/previous profession/job (If applicable)

Government/other service? -----------------------------------

Designation--------------------------------------------------------

Monthly Salary/Income--------------------------------------- (Taka)

Organization name & Address-------------------------------

Did you ever get expelled/resigned/dismissed/terminated from gov ernment

/other Job? Yes /No------

If yes then describe details with date (Character limits 200)-------------------

---------------------------------------------- -------------------------------------------
-----------------------------------------------------------------------------------------

MILITARY SERVICE

Your present/ previous service at Army/Navy/Air Force (If any). Include if

you previously joined Academies (Army/Navy/Air Force).

Date of enrollment------------------------------------

Designations/posts held-----------------------------

Current employment if in service-----------------

Regiment/Unit/Training Academy (name and location) ------------------------

--------------------------------

Reasons if released/ left from military or from Academies ---------------------

-----------------------------------------------------------------------------------------
--------------------------------------------- -------------------------
MISCELLANEOUS INFORMATION

Have you ever suffered from serious disease as mentioned below? If yes to
any then describe in short

Physical Illness-----------------------------------------------------------------------

Injury---------------------------------------------------------------------------------

Surgery-------------------------------------------------------------------------------

Mental disorder----------------------------------------------------------------------

Others---------------------------------------------------------------------------------

Physical Structure (Thin built/Medium built/Short built ) ----------------------

-------------------------------------------

Complexion----------------------------------

Visible Identification Mark---------------------------------------------------------

Height in cm. ---------------------------------

Weight in kg----------------------------------

Mother tongue---------------------------------------

Efficiency in other Languages-

Language----------------------- (Speak? / Read? / Write?)----------------

Language----------------------- (Speak? / Read? / Write?) ----------------

Language----------------------- (Speak? / Read? / Write?) ----------------

Favourite Study Subjects------------------------------------------------------------

-----------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------

Places visited (Inside Bangladesh) ------------------------------------------------

----------------------------------------------

Places visited (Outside Bangladesh) -----------------------------------------------

--------------------------------------------
Marital Status: (if applicable) -------

(Married /Unmarried/ Separated /Divorced /Widow/Widower/ Any other)-

--------------------------------------

Date of Marriage--------------------------------

Date of Separation/divorce etc (If Applicable) ----------------------------------

No of Children if Married/Widow/Widower -------------------------------------

Name & Occupation of Husband/Wife

---------------------------------------------------------------------------------- ------

FAMILY DETAILS

Father's name------------------------------------------------------

Father's Education/Qualification-------------------------------

Father's Occupation with Designation---------------------------------------------

(mention if retired)

Organization name & address------------------------------------------------------

(mention if retired)

Monthly Income-------------------------------------------

Is your father dead? --------------------------------------

Is your father divorced? ---------------------------------

If your father divorced then mention date-----------

Did your father marry more than once ? --------------

Mother's name--------------------------------------------

Mother's Education/Qualification ---------------------

Mother's Occupation with Designation--------------------------------------------

(mention if retired)

Organization name & address------------------------------------------------------

---------------- (mention if retired)
Monthly Income--------------------------------------------

Is your mother dead? --------------------------------------

Is your mother divorced? --------------------------------

If your mother divorced then mention date--------

Did your mother marry more than once? -----------

Step Father (if applicable)

Name-----------------------------------------------

Address---------------------------------------------

Step Mother (if applicable)

Name-----------------------------------------------

Address---------------------------------------------

Parent's Residential Address-------------------------------------------------------

----------------------------------------------

Other Sources of Income (If any)

Sources of Monthly/yearly Amount Short description

Income

Details of Guardian (If not parents)

Name----------------------------------------------------------------------------------

Relation-------------------------------------------------------------------------------

Mobile No------------------------------------

Guardian's Address------------------------------------------------------------------

Guardian’s Occupation--------------------------------------------------------------

Gordian’s Designation---------------------------------------------------------------
RELATIVES

Grand father's Name & Occupation------------------------------------------------

--------------------------------------------

Brothers /Step Brothers: (if you have step brothers, first write all
brothers’ details and thereafter the details of Step Brothers )

Brothers (as per sibling order)

Name----------------------------------------------------------------------------------

Age (in years) ------------

Sibling order-------------

Education/Qualification-----------------

Occupation (Designation & Organization name ) --------------------------------

-----------------------------------------

If married then wife's Name--------------------------------------------------------

Wife's Age (in years) ---------------------

Wife's Education/Qualification -----------------------------------------------------

--------------------------------------------

Wife's Occupation (Designation & Organization name ) -------------------------

------------------------------------------

Step Brothers (as per sibling order)

Name----------------------------------------------------------------------------------

Age (in years) ------------

Sibling order-------------

Education/Qualification-----------------

Occupation (Designation & Organization name ) --------------------------------

-----------------------------------------

If married then wife's Name--------------------------------------------------------

Wife's Age (in years) ---------------------

Wife's Education/Qualification -----------------------------------------------------

Wife's Occupation (Designation & Organization name) -------------------------

------------------------------------------

Sisters /Step Sisters :( if you have step Sisters, first write all
Sisters’ details and thereafter the details of Step Sisters)

Sisters (as per sibling order)

Sister's Name-------------------------------------------------------------------------

Sister's Age (in years) ------------------

Sibling order-----------------------------

Education/Qualification--------------

Sister's Occupation--------------------

If married then husband’s Name---------------------------------------------------

Husband's Age (in years) ----------------

Husband's Education/Qualification ------------------------------------------------

-------------------------------------------

Husband's Occupation (Designation & Organization name ) --------------------

----------------------------------------

Step Sisters (as per sibling order)

Sister's Name-------------------------------------------------------------------------

Sister's Age (in years) ------------------

Sibling order-----------------------------

Education/Qualification--------------

Sister's Occupation--------------------

If married then husband’s Name---------------------------------------------------

Husband's Age (in years) ----------------

Husband's Education/Qualification ------------------------------------------------

Husband's Occupation (Designation & Organization name ) --------------------
----------------------------------------
Uncles

Paternal/Maternal Uncle

Paternal Uncles

Uncle's Name-------------------------------------------------------------------------

Uncle's Age (in years) ----------------------------

Education/Qualification-------------------------

Uncle's Occupation (Designation & Organization name ) -----------------------

------------------------------------------

If married then wife's Name--------------------------------------------------------

---------------------------------------------

Wife's Age (in years) ---------------

Wife's Education/Qualification-------------------

Wife's Occupation (Designation & Organization name ) -------------------------

---------------------------------------

Maternal Uncles

Uncle's Name------------------------------------------------------------------- ------

Uncle's Age (in years) ----------------------------

Education/Qualification-------------------------

Uncle's Occupation (Designation & Organization name ) -----------------------

------------------------------------------

If married then wife's Name--------------------------------------------------------

Wife's Age (in years) ---------------

Wife's Education/Qualification -------------------

Wife's Occupation (Designation & Organization name ) -------------------------

---------------------------------------
Paternal/Maternal Aunt

Paternal Aunts

Aunt's Name--------------------------------------------------------------------------

Aunt's Age (in years) -----------------------

Sibling order--------------------

Education/Qualification---------------------

Aunt's Occupation (Designation & Organization name ) ------------------------

------------------------------------

If married then husband’s Name---------------------------------------------------

Husband's Age (in years) -------------------------------

Husband's Education/Qualification ---------------------

Husband's Occupation (Designation & Organization name ) --------------------

-----------------------------------

Maternal Aunts

Aunt's Name------------------------------------------------------------------ --------

---------------------------------------

Aunt's Age (in years) -----------------------

Sibling order--------------------

Education/Qualification---------------------

Aunt's Occupation (Designation & Organization name ) ------------------------

------------------------------------

If married then husband’s Name---------------------------------------------------

Husband's Age (in years) -------------------------------

Husband's Education/Qualification ---------------------

Husband's Occupation (Designation & Organization name ) --------------------

-----------------------------------
Important personalities among the relatives /associates

(Military officers, government /non - government officers/industrialists/

social activists……)

Name Relation Designation Address