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  • pg 1
									                        Government of the People's Republic of Bangladesh                                                    34th BCS Examination 2013
                        Bangladesh Public Service Commission                                                                 Applicant's Copy

 User ID: CSNNXXHS                                                                                                                                        BPSC Form - 1
 Exam Centre: DHAKA                                                                                                     General and Technical/Professional (Both) Cadre

                                          Applicant's Name                         GOLAM MORTOZA
                                          Father's Name                            GOLAM QUIBRIA
                                          Mother's Name                            MOST. HOSSNEARA KHATUN
                                          Date of Birth                            1987-01-21 [YYYY-MM-DD]
                                          Contact Mobile                           01719303303
                                          Freedom Fighter Status                   Non Freedom Fighter
                                          Handicapped                              None
                                          National ID Number                       5013961992400
                                          Gender                                   Male

 Home District              Kushtia                                                 Tribal Status                  No
 Marital Status             Single                                                  Employment Status              Not Employed
                            GOLAM QUIBRIA                                                                          GOLAM QUIBRIA
                            HOSSNABAD                                                                              HOSSNABAD
                            Kushtia                                                                                Kushtia
 Present Address                                                                    Permanent Address
                            Daulatpur                                                                              Daulatpur
                            HOSSNABAD                                                                              HOSSNABAD
                            7052                                                                                   7052

Educational Qualifications:

          Examination                              Board/Institute                 Group/Subject/Degree                  Result          Year         Roll        Duration
             S.S.C                                    Jessore                             Science                            4.25        2001        131200         N/A
             H.S.C                                    Rajshahi                            Science                            3.30        2003        101197         N/A
            Honours                              National University                      Physics                             3          2008         N/A              4
      Post Related Subject            Physics [511-512]

Cadre Choice - General and Technical/Professional (Both) Cadre

 Choice           01       02        03     04        05      06       07    08    09      10       11       12         13          14   15     16   17      18   19       20
 Code             112     114    110        117      111     122       115   118   116    126       124      121     123          119    610    0     0       0    0       0

I declare that the information provided in this form are correct, true and complete to the best of my knowledge and belief. If any information is found
false, incorrect, incomplete or if any ineligibility is detected before or after the examination, any action can be taken against me by the Commission
including cancellation of my candidature.

                                                                                                          -------------------- Applicant's Signature --------------------

© 2013, Bangladesh Public Service Commission, All Rights Reserved.                                                                              powered by
Congratulations!! Application Submitted Successfully
Please print this page. It may be downloaded as PDF file and it will remain open to download by using USER ID & PASSWORD (available after

CSNNXXHS is your User ID, Please keep this number to pay the application fee within 2013-03-21 19:23:24[YYYY-MM-DD hrs:min:sec] from
any Teletalk prepaid mobile phone by SMS.
1st - SMS Format: BPSC <space> User ID and send SMS to 16222 [Example : BPSC CSNNXXHS]
1st SMS Reply: Returns a PIN like 23423456
2nd - SMS Format: BPSC <space> YES <space> PIN and send SMS to 16222 [Example : BPSC YES 23423456]
2nd SMS Reply: Returns a USER ID & PASSWORD

© 2013, Bangladesh Public Service Commission, All Rights Reserved.                                                     powered by

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