Application for Scholarship in MEPhI, Russian Federation

Session: 2019-2020

1. Name : Khaja Md. Azmayin Ahmed Apon

2. Gender : Male
3. Father’s Name : Khaja Md. Khokon Mahmud
4. Mother’s Name : Mosammat Asma Begum
5. Date of Birth and Age on 1st January 2019 : 16/08/1996, 22 years 04 Months 16 Days
6. Nationality : Bangladeshi
7. Permanent Address : Village: Baluavata, Ward No.:07, House
No.:315, Post: Badarganj, District: Rangpur
8. Present Address : Block: G1, Road No.:12, House No.:05, Mirpur-
02, Dhaka-1216
9. Passport No.(If any) : On progress
10. Contact No. : 01732293270, 01943617494, 01915856023
11. National ID No. : 19964714075000243
12. e-mail Address : khajaapon1996@gmail.com
13. Marital Status : Unmarried
14. Education:
Name of Name of Subject Name of Institution Year of Obtained
Diploma/Degree Passing CGPA
B.Sc Electrical & Electronic KUET 2018 3.82(out of
Engineering (EEE) 4.00)
H.S.C Science Carmichael College, 2013 5.00(golden)
Rangpur
S.S.C Science Cantonment Public School 2011 5.00(golden)
& College, Dinajpur

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Applicant’s Signature