Admition From-25
SHAHEED LT MUSHFIQ HIGH SCHOOL
Guimara Region, Khagrachari
Stablished-2000
Web:www.mushfiqschool.edu.bd, Email- shaheed.mhs@gmail.com
EIIN: 135014
(ADMISSION FORM)
Serial No —————–
Class in which admission is being sought —————————————————————
1. Full Name in English (Block Letter) ————————————————————–
2. Date of Birth: ——————————————————————————————
3. Age: ———————– Year: ————— Month: ———————Days: —————
4. Nationality: ——————————– Religion: ———————— Caste: ————–
5. Father’s Name: —————————————————————————————-
6. Occupation of Father: ——————————————————————————-
a. Rank: ——————————————- Unit: ————————————
b. Location: ————————————— Phone No——————————
7. Mother’s Name: ————————————————————————————–
8. Occupation of Mother: ———————————- Phone No: —————————-
9. Present Address: ————————————————————————————–
————————————————————————————-
10. Permanent Address: ——————————————————————————–
——————————————————————————-
11. School Last Attended: ——————————————————————————
SOME IMPORTANT DATA ABOUT THE CHILD
1. Parents observation about the child’s talents aptitude skill etc. (Music, Games, Debate, Art etc)
——————————————————————————————————————————————————————————————————————————————
2. In case of emergency whom to inform (Other than the parents)
Name: —————————————————————————————————
Phone: ——————————————————- Work: ———————————-
Contact address: —————————————————————————————
I/We hereby declare that the information furnished in this application form is correct to best of my/ our knowledge.
Signature of Father/ Guardian Signature of Mother Date
Date: Signature of Headmaster