Kushtia Govt.

College
www.kushtiagovcollege.edu.bd
Admission Form
Group: HSC - Science
Session: 2023-2024
Track No: 906

EIIN: 117808 Class Roll: 1202324010383 Security Code/PIN:

Transaction No: AIR1RD0UFB (bKash) Application Date: 27-Sep-2023 Merit Position:

01. Student Name (English) : MD. MAHIN AHMED DIP (বাংলায়) : মাঃ মািহন আহেদ ীপ
Student's NID/Birth Reg. : 20075026005274753
Student's Phone : 01729880859

02. Father's Name : MIR ABU SALAK

Father's NID : 5019473000001
Father's/Guardian's Phone : 01725231542

03. Mother's Name : MST. SHIULY

Mother's NID : 5503088253
Mother's Phone : 01725231542

04. Permanent Address : District: Kushtia

shordar para, udibari, Kushtia Sadar, kushtia

05. Present Address : District: Kushtia

shordar para, udibari, Kushtia Sadar, kushtia

06. Local Guardian Name, Address & Phone :

07. Nationality : Bangladeshi

08. Father's Occupation : 11. Father's Annual Income :0
09. Date of Birth : 30-Dec-2007 12. Quota : no
10. Religion : Islam 13. Blood Group : A+

14. SSC & HSC/Equivalent Examinations Detail :

Exam Name Exam Roll Reg No Session Division Exam Year Board/Instit. GPA
SSC/Equivalent 125634 2013573111 2021-2022 SSC - Science 2023 jashore 5.00

15. Subject List

Subject Code Subject Name Subject Type
101 Bangla 1st paper mandatory
107 English 1st paper mandatory
174 Physics 1st paper mandatory
176 Chemistry 1st paper mandatory
275 ICT mandatory
178 Biology 1st paper elective
265 Higher Math 1st paper fourth

16. আিম অীকার করিছ য,

/

ক) উপের বিণত তথসমূ হ সত ও সিঠক। খ) কেলেজর নূ নতম ৮০% ােস উপিত থাকেত বাধ থাকব। গ) আিম কেলেজর িবধান সমূ হ মেন চলেত বাধ থাকব /

এবং কেলেজর শাি-শৃ লা ও িনয়ম পিরপী কােজ জিড়ত থাকেল বা ভূ ল তথ দান করেল কতৄপ দ য কান শাি হেন বাধ থাকব।

17. Admission Fee: TK.1957/=

Student's Signature Signature of Convenor Signature of Principal