The Glass House (Level 13)

S E (B)-2, 38 Gulshan Avenue, Gulshan-1, Dhaka 1212

Web: https://www.shanta-aml.com

EMPLOYEE INFORMATION
Name * (As per NID)
Designation *

Department *
Job Location *

Date of Joining * DD MM YYYY

Date of Birth * As per NID: DD MM YYYY Actual: DD MM YYYY
Place of Birth
Personal Mobile No * Official Mobile No *
Personal E-mail ID *
Passport No / Birth Cerificate
National ID No *
Emergency Contact No *

Emergency Contact Person *

Relationship With Emergency
Contact Person *

Name of the Bank*

Account Holder Name* Branch Name*
Bank A/C Number* Routing No*
 EMPLOYEE INFORMATION

Nationality *
Religion *
Gender * Male Female
Blood Group *

Last Academic Certification *

Name of Institute *

Last Organization * Last Designation *

Professional Certifications (If Any)

Marital Status * Single Married

Name of Spouse *
Date of Birth*

Nominee Name *
Nominee NID Number* Relationship*
Nominee Contact Number*

Father's Name *
Mother's Name *

Present Address *

Permanent Address *

Child 1 (Name)
Date of Birth
Child 2 (Name)
Date of Birth

Mandatory Fields: *