Government of the People's Republic of Bangladesh

Bangladesh Public Service Commission Applicant's Copy

Application Form for Non-Cadre Examination [BPSC Form - 5 A]

User ID: NSHRNDYRJW Ref: 01-57/2018, Date: 24/01/2018

Post Name Building Oversher

Exam Centre DHAKA
Applicant's Name MD. IMRAN KHAN
Father's Name MD. ALAUDDIN KHAN
Mother's Name RASHIDA KHATUN
Date of Birth 1996-03-13 [YYYY-MM-DD] 21 Years 9 Months 20 Days
Gender Male

Freedom Fighter Status Non Freedom Fighter Ethnic Minority No

Marital Status Single Physically Handicapped No
National ID NO 19967617269000036 Home District Pabna

Present Address: Permanent Address:

Care of: MD. ALAUDDIN KHAN Care of: MD. ALAUDDIN KHAN
Village/Town: JOSHOMONTODULIA Village/Town: JOSHOMONTODULIA
Post Office: PORADANGA Post Office: PORADANGA
Post Code: 6670 Post Code: 6670
Upazilla/Thana: Santhia Upazilla/Thana: Santhia
District: Pabna District: Pabna

Academic Qualifications:

Examination Board/Institute Group/Subject/Degree Result Year Roll Duration

S.S.C Rajshahi Science 4.88 2011 155003 N/A

Diploma Technical Civil Technology 3.71 2015 506724 N/A
I declare that the information provided in this form are correct, true and complete to the best of my knowledge and belief. If any information is found
false, incorrect, incomplete or if any ineligibility is detected before or after the examination, any action can be taken against me by the Commission
including cancellation of my candidature.

-------------- Applicant's Signature --------------

Congratulations!! Application Submitted Successfully

NSHRNDYRJW is your User ID, Please keep this number to pay the application fee within 2018-02-28 00:48:07[YYYY-MM-DD
hrs:min:sec] from any Teletalk prepaid mobile phone by SMS.
1st - SMS Format: BPSC <space> <User ID> and send SMS to 16222
[Example : BPSC NSHRNDYRJW]. 1st-SMS Reply: Returns a PIN (8 Digits) like 23423495
2nd - SMS Format: BPSC <space> <YES> <space> <PIN> and send SMS to 16222
[Example : BPSC YES 23423495]. 2nd-SMS Reply: Returns a USER ID & PASSWORD

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