(To be Sent Naval Headquarters after Filled up)

Tracking No : 240129092207262 Form Commission -1A

BANGLADESH NAVY
Application Form (Officer Cadet)

Roll No: BN 2530114 Batch No: OC-2025A

(Will be filled up by Naval Headquarters) (Please see the instructions given in page 2)
1. Full Name: MEHERAB ZAMAN
(As per SSC/O'Level Certificate)
2. Present Address: Village/House/Flat: HOLDING NO 322/2, PANTHAPARA(MP PARA)
Road: MP PARA Post Office: GOBINDAGONJ Post Code: 5740
Police Station: Gobindagonj District: Gaibandha
Phone/Mobile(Self): 01585546150 E-mail: mzratul.apon@gmail.com
3. Permanent Address: Village/House/Flat: HOLDING NO 322/2, PANTHAPARA(MP PARA)
Road: MP PARA Post Office: GOBINDAGONJ Post Code: 5740
Police Station: Gobindagonj District: Gaibandha
Phone/Mobile(Parents): 01585546150
4. Birth Information & Gender:
(a)Date of Birth:19-09-2006 (b)Gender: Male Preliminary Test
Preliminary Medical Test:
(c)Place of Birth: GAIBANDHA
Preliminary Interview:
(d)Age: 18 Years 03 Months 13 Days Written:
(On the date mentioned in the circular)

5. Nationality:
(a)Candidate's Nationality: BANGLADESHI
(b)Father's Nationality: BANGLADESHI Officer's Signature(with Seal)

(c)Mother's Nationality BANGLADESHI

6. Religion: Muslim 7. Marital Status: Unmarried ISSB Remarks
Board Batch No:
8. Transaction No: 202402250710566662
Remarks:
9. (a) Height: 172.72 CM (b) Weight:56 KG
(c) Chest Normal: 32 Inch (d) Chest Extended: 34 Inch
10.Visible Identification Mark: Birth mark on left hand
Officer's Signature(with Seal)
11.Parental Information
a. Father's (Legitimate) Full Name : MD KAMRUZZAMAN
Final Medical Test
b. Father's Educational Qualification : Comments:
MSC
c. Mother's (Legitimate) Full Name : MST HALIMA KHATUN
d. Mother's Educational Qualification : Officer's Signature(with Seal)
BA
e. Parent's Present Address : Final Selection Board
HOLDING NO 322/2, PANTHAPARA(MP PARA), Ghaibandha, Comments:
Gobindagonj, Gaibandha
f. Father's Occupation with Designation and Organization :
Lecturer, Department of statistics, Gobindagonj government college, Officer's Signature(with Seal)
Gobindagonj, Gaibandha , Lecturer
g. Mother's Occupation with Designation and Organization :
Assistant teacher, Baluvora Government Primary School, Gobindagonj,
Gaibandha , Assistant teacher

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 h.Parent/Legal Guardian Source of Income : Father
i.Parent/Legal Guardian Monthly Income : 38440
12.Details of Guardian (if not father):
(a)Name: MD KAMAL HOSSAIN PK
(b)Relation: UNCLE (c)Mobile No:01712412106
(d)Guardian Income Source: Government job (e) Income: 30000
(f) Guardian Occupation with Office Address: Assistant teacher at government primary school, Bihigram,
Adomdighi, Bogura
13.Records of Educational Institutions Attended:
Exam Name of Institutions with Address Year Result
Bojrukh boaliya regi: government primary school,
PSC/Equivlent 2016 GPA 5.00
Gobindagonj, Gaibandha
JSC/Equivlent TMSS PUBLIC SCHOOL AND COLLEGE, BOGURA 2019 4.86
14.Details of Educational Qualification:
Group/ Passing Registration
Type GPA/Grade Name of Institution With place Roll No Board
Subject Year No
GPA : 5.00
TMSS PUBLIC SCHOOL AND
Math : A+
SSC 2022 COLLEGE, BOGURA, 163325 1912816626 Rajshahi
Physics : A+
Bogura
English : A+
Appeard, HSC, Rajshahi Armed Police Battalion Public school & college, Bogura, Bogura
15.Proficiency in Games and Hobby:
(a)Hobby: DRAWING
(b)Games: -
16.Previous Inter Service Selection Board (ISSB) Information:
Batch No of Inter Service Selection Board Date Result

17.Have you faced any criminal charge? (if yes then attach all papers): No
18.Statements:
(a) I, do hereby, state that
(i) The above information is correct and true. If any information is found false; I shall be subject to
any lawful action taken by the Naval Headquarters.
(ii) If any information found to be false/incorrect during my training; I shall be subject to any lawful
action taken by the Naval Headquarters. If I am withdrawn from training for the above reason; I
shall be liable to pay all the training expenditure.
(iii) If I sustain any injury or die during ISSB test; the Bangladesh Government or any Government
employee will not be liable.
(b) I have the parental consent regarding the above statement.

Date (Applicant Signature)

Meherab Zaman

SPECIAL INSTRUCTIONS
(a) Candidate has to fill up the form by himself.
(b) Application will be treated as canceled for incorrect/incomplete/false information.
(c) Service personnel will have to apply through proper authority.

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