APPLICANT PERSONAL HISTORY

Service: Batch/Course: AMC-81 Roll No: 811268

Army

1. Name (In English): Tanzim Rafat

2. Name (In bangla):

3. NID No:

4. Contact Information.

a. Mobile No: 01521246094 (tel:01521246094)

b. Email Address: 1@gmail.com
c. FB Id:
d. Permanent Address:
e. Present Address:
5. Birth information.

a. Date of Birth: 1996-11-16

b. Place of Birth:
c. Birth District:
6. Nationality.

a. Candidate's Nationality: Others

b. Father's Nationality:
c. Father's Nationality Type:
d. Mother's Nationality:
e. Mother's Nationality Type:
f. If parent's Nationality is not Bangladeshi by birth?
i. Entry date in Bangladesh: 0000-00-00 (tel:0000-00-00)
ii. Country from:
7. Religion.
a. Name of Religion:
b. Cast:
:
 8. Detail of Educational Qualification.
a. S.S.C, H.S.C & higher education details:

Exam Branch Language Educational Board/University Passing Result

Name/Level (science, medium Institute Year (Division
arts, (Bangla / Board/University /Class/GPA)
commerce English
etc)/Subject etc)

9. Have you ever been expelled from any educational institution? If so, provide
following details.

Year of occurrence Educational Institute Name Reason

10. Break of study if.

Duration Reason Last Exam appeared before break

From To
:
 11. Games and Extracurricular Activities.

Game/Extracurricular activities Institution (If related) Award / Achievement (If any)

12. Hobby.

Hobby Institution (If related) Award / Achievement (If any)

:
 13. ISSB Info.
Previous appearance in ISSB (If appeared) as Army /Navy/ Air force candidate:

Course Roll NO Year & Month of Appearance Result

14. Preparation for ISSB.

Name of institution and address Duration Learned subjects/ items

:
 15. Legal Issues.
a. Have you ever been arrested, indicted or summoned into court, or convicted, fined
or imprisoned for the violation of any law?
b. Had you been arrested by police at anytime?
c. Case Detail:
16. Your present profession/job (If applicable).
a. Profession/Job

Designation Organization Name & Governmental / Monthly

Address Other job Salary/Income

b. Did you ever get expelled/resigned/dismissed/terminated from govt./other Job?

c. Details (If yes to above):
17. Your present/ previous service at Army/Navy/Air Force (if any). Include details if
you previously joined Academies (Army /Navy/ Air Force) - Not Applicable.

Date of Regiment/unit/Training Designations/posts Current Reasons if

enrollment Academy(name and held employment released/
location) if in service left from
military or
from
Academies
:
 18. Applicant's Additional Information.
a. Injury/Illness/Disorder:

b. Physical Structure: c. Complexion:

d. Height: cm. e. Weight: kg.
f. Visible Identification mark: g. Mother Tongue:
h. Proficiency in other language:

Language Read Write Speak

English

Arabic

French

Chinese

Russian

19. Favourite Matters.

Favorite Study Subject Places Visited (In BD) Places Visited (Out of BD)

20. Marital Status.

Marital Date of Date of No of Children Name & Occupation

Status marriage Separation if applicable of husband/wife:

0000-00-00 0000-00-00 0
(tel:0000-00-00) (tel:0000-00-00)

21. Have you ever suffered from serious disease like physical
injury/surgery/infection?

Illness/Injury/surgery/mental disorder etc Description/ details

:
 22. Family Details.

Relation Education Occupation Monthly Dead? Other Information

& Name detail Income

Father TK. a. Is your father divorced?

b. If your father divorced
then when? 0000-00-00
(tel:0000-00-00)
c. Did your father marry
more than once?

Mother TK. a. Is your mother

divorced?
b. If your mother divorced
then when? 0000-00-00
(tel:0000-00-00)
c. Did your mother marry
more than once?

Step
Father

Step
Mother

23. Other Sources of Income (If any).

Source of Income Monthly/Yearly Amount Short Description

24. Parent's Residential Address.

25. Details of Guardian (If not parents).
Name: Relation: Mobile No:
Guardian's Address: Gurdian's Occupation: Gurdian's Designation:
:
 26. Nearest Relatives.

Grand father's Name & Grand mother's Name &

Occupation(paternal) Occupation(Paternal)

Grand father's Name & Grand mother's Name &

Occupation(maternal) Occupation(maternal)

27. Brothers and Sisters.

a. Number of Brothers and Sisters.
Brother: 0 Step Brother: 0 Sister: 0 Step Sister: 0
b. Details of Brothers.

Relation Name Age Sibling Education / Profession If Married

Order Qualification

Wife's Name:
Age:
Education/Qual:
Profession:

c. Details of Sisters.

Relation Name Age Sibling Education / Profession If Married

Order Qualification

Husband's
Name:
Age:
Education/Qual:
Profession:

28. Uncles and Aunts.

a. Details of Uncles.

Relation Name Age Education / Profession If Married

Qualification

Wife's Name:
Age:
Education/Qual:
Profession:

b. Details of Aunts.

Relation Name Age Education / Profession If Married

Qualification

Husband's
Name:
Age:
Education/Qual:
Profession:

29. Important personality among the relatives/closely intimates.

:
 Name Relation Occupation & Designation in details Present Address
:
 RESUME CHECKS

Candidate's Gender Date Applying for Previous Previous

Name of Regular/short attendance (In attendance (In
Birth course? Long course) Short course)

Tanzim Male 1996-

Rafat 11-16

District Thana Postal District Thana Postal

(Permanent (Permanent Code (Present (Present Code
Address) Address) Address) Address)

SSC/Equivalent Education Result Range of GPA(SSC/Equivalent)

HSC/Equivalent
College/Institute Name

EIIN Roll No Board Year

Registration No HSC/Equivalent Range of

Education Result GPA(HSC/Equivalent)

Father's Name

Education Profession Category Rank/Designation

Professional Type Income Tk

Mother's Name

Education Profession Category Rank/Designation

Professional Type Income Tk

Brother's & Sisters

Having Brother's And Sister's No Total Brothers and Ordinal

(Yes/No) Sisters Position

I herby declare that all information given are correct and I have not hidden anything to the best
of my knowledge.

Submitted by
Tanzim Rafat
: