e-School

Shaheed Smarak College

Admission Year: *

Course/Class *

First Name: *

Middle Name:

Last Name: *

Date Of Birth(BS): *

Date Of Birth(AD): *

Gender: *

Male Female Other

Nationality:

Ethnicty:

Religion:

Student's Mobile: *

Student's Email:

Province:

District:

Municipality/VDC:

Ward No:

Address :

Father's Name:*

Father's Phone No:

Mother's Name:

Mother's Phone No:

Local Guardian's Name:*

Local Guardian's Mobile No:*

Class: *

Passed Year:*

GPA:*

School/College Name:*

School Address:

Name (Referred by):

Contact No. (Referred by):

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