gva¨wgK I D”Pgva¨wgK wk¶v †evW©, XvKv|
www.dhakaeducationboard.gov.bd
(QvÎ/QvÎxi bvg, wcZv, gvZvi bvg, c`ex ms‡kva‡bi Av‡e`bcÎ)
1| QvÎ/QvÎxi bvg (†ev‡W©i cix¶vi di‡g/mb‡` †h iKg †jLv Av‡Q ) t
(Bs‡iwR eo A¶‡i) ........................................................................................................................................
2| QvÎ/QvÎxi wcZvi bvg (†ev‡W©i cix¶vi di‡g/mb‡` †h iKg †jLv Av‡Q) t
(Bs‡iwR eo A¶‡i) ........................................................................................................................................
3| gvZvi bvg (†ev‡W©i cix¶vi di‡g/mb‡` †h iKg †jLv Av‡Q) t
(cÖ‡hvR¨ n‡j) ................................................................................................................................................
4| †hvMv‡hv‡Mi wVKvbv t MÖvg/evox bs t .......................................................WvKNi t .................................................
_vbv t .......................................................................... †Rjv t ......................................................................
5| QvÎ/QvÎxwU †h cÖwZôvb n‡Z †RGmwm/GmGmwm/GBPGmwm cix¶vq AskMÖnY K‡i‡Q Zvi c~Y©
wVKvbv t .......................................................................................................................................................
6| †ev‡W©i †h cix¶vq AeËxY© n‡q‡Q Zvi bvg t
(K) †RGmwm t †K›`ª t ......................... †ivj bs t ..........................................cix¶vi eQi t ..............................
(L) GmGmwm t †K›`ª t .......................... †ivj bs t ..........................................cix¶vi eQi t .............................
(M) GBPGmwm t †K›`ª t ......................... †ivj bs t ...........................................cix¶vi eQi t ............................
7| QvÎ/QvÎxwU †h †kªYx‡Z Aa¨qb Ki‡Q t .................................................................................................................
8| †ev‡W©i †h cix¶vq QvÎ/QvÎxwUi bvg ms‡kvab Ki‡Z n‡e t †RGmwm/GmGmwm/GBPGmwm
9| QvÎ/QvÎxwU ms‡kvab K‡i †h bvg Ki‡Z Pvq t
(Bs‡iwR‡Z eo A¶‡i)......................................................................................................................................
(K) QvÎ/QvÎxwU ms‡kvab K‡i wcZvi †h bvg Ki‡Z Pvq t
(Bs‡iwR‡Z eo A¶‡i)......................................................................................................................................
(L) QvÎ/QvÎxwU ms‡kvab K‡i gvZvi †h bvg Ki‡Z Pvq t
(Bs‡iwR‡Z eo A¶‡i)......................................................................................................................................
10| bvg ms‡kvab Kivi KviY t ................................................................................................................................
11| we`¨vjq/gnvwe`¨vjq cÖav‡bi gšÍe¨ I ¯^v¶i t ........................................................................................................
†h mK
j KvMRcÎ G di‡gi mv‡_ `vwLj Ki‡Z n‡e t
(K) w
d eve` ev‡W©i mwP‡ei AbyK~‡j cªwZ cix¶vi Rb¨ 500/- UvKvi †mvbvjx e¨vs‡Ki wWgvÛ WªvdU(wWgvÛ Wªvd‡Ui Dcwifv‡M cÖvc‡Ki
bvg A_©vr mwPe, gva¨wgK I D”Pgva¨wgK wk¶v †evW©, Kzwgjøv wjLevi wVK c‡iB e¨vsK KZ…©c‡¶i UvKv RgvKvixi A_©vr hvi c‡¶ UvKv Rgv
Kiv n‡jv Zvi bvg D‡j¬L K‡i w`‡Z n‡e|
(L) bb-RywWwkqvj ÷¨v‡¤ú wcZv KZ…©K g †kªYxi g¨vwR‡÷ªU/†bvUvwi cvewj‡Ki wbKU Zvi —v‡bi (mswk¬ó QvÎ/QvÎxi) wcZvi/gvZvi bvg
ms‡kvab ^‡× Gwd‡WwfU Ki‡Z n‡e Ges H Gwd‡WwfU Gi g~j Kwc cvVv‡Z n‡e| wcZv RxweZ bv _vK‡j gvZv‡K Gwd‡WwfU Ki‡Z
n‡e| wcZv I gvZv DfqB RxweZ bv _vK‡j AvBbvbyM AwffveK Gwd‡WwfU Ki‡Z cvi‡e, Z‡e AvBbvbyM AwffveKm¤ú‡K© †Rjv R‡Ri
mvwU©wd‡KUI cvVv‡Z n‡e| ïaygvÎ wb‡Ri bvg ms‡kva‡bi ¶‡Î Av‡e`bKvix QvÎ/QvÎxi eqm hw` 18 eQi A_ev Zvi †ekx nq Zvn‡j
wb‡RB Gwd‡WwfU Ki‡Z cvi‡e|
(M) cÖv_x©i bvg, wcZvi bvg I gvZvi bvg ms‡kva‡bi Rb¨ evsjv‡`‡ki †h †Kvb •`wbK cwÎKvq cÖKvwkZ weÁwßi (cwÎKvi bvg I ZvwiL
D‡j¬L K‡i) g~j KvwUs Rgv w`‡Z n‡e|
cwÎKvi bvg t...................................................................................................................ZvwiLt...................................
(N)
িন�gva¨wgK, gva¨wgK I D”Pgva¨wgK cix¶vi mvwU©wd‡KU (g~j mvwU©wd‡KU bv †c‡q _vK‡j cix¶vi gvK©wmU) Gi mZ¨vwqZ Kwc|
(O) †RGmwm, GmGmwm I GBPGmwm cix¶vi †iwR‡÷ªkb KvW© Ges cÖ‡ekc‡Îi mZ¨vwqZ Kwc|
(P) wk¶v cÖwZôv‡bi cÖavb KZ…©K GK Kwc mZ¨vwqZ Qwe|
wet `ªt Am¤ú~Y© ev ÎæwUc~Y© Av‡e`bcÎ we‡ePbvi †hvM¨ bq|
we`¨vjq
/gnvwe`¨vjq cÖav‡bi ¯^v¶i
(we`¨vj
q/gnvwe`¨vj‡qi wmj) QvÎ/QvÎxi ¯^v¶i I c~Y© bvg
click to sign
signature
click to edit
click to sign
signature
click to edit