Dhaka College English Club
Membership Form
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Your Full Name *
Example: Kazi Nazrul Islam
Gender *
Male  / Female
Date of Birth *
August 24, 1990
MM
/
DD
/
YYYY
Current Address *
Example: 67/2A Dhanmondi, Dhaka-1215
Permanant Address *
Example: Holding no 160, Ward- 01, Jhalakati-8400
Guardian's name & Cell Number *
Example: Abu Haidar Ali   Cell: 8801717335689
Personal Mobile Number *
Example: 8801911698745
Emalil Address *
Your Facebook Account URL *
Provide a link to your picture *
Please provide a publicly accessible link to your picture. You can do this by right clicking on your facebook picture and then choosing 'open image in a new tab'. You can provide the link to the image here.
Name of Educational Institution and Department with session/Batch *
Example: Dhaka College, English Department Session: 2010-2011
Language Course *
SSC Department and GPA *
Example: SCIENCE 4.50
HSC Department and GPA *
Example: Science 5.00
Blood Group *
Example: O Positive
Click on the following box in which field you have excelent knowledge *
Required
Why do you want to be the part of us? *
Give valid resons and be honest about your speech.
How did you know about us? *
Money Receipt Number *
(Collect it from Dhaka College English Department paying TK. 500)
Advisor's Name *
Who has signed on your money receipt.
Submit
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