Govt. Zia Mohila College
(Application Form)
Personal Information
Academic Information
Address
Guardian's Information
Apply Date :
Student's Name :
**
Gender :
**
Male
Female
Religion :
**
Select One
Islam
Hindu
Buddha
Christian
Other
Blood Group :
Select One
A+
A-
O+
O-
B+
B-
AB+
AB-
Father's Name :
**
Mother's Name :
**
Date of birth :
**
Image :
Admission Desire(Class):
Select Class :
**
Select One
Eleven
Twelve
Honours
Degree
Mastes
Group :
**
Session :
**
2022-2023
2021-2022
2020-2021
2023
2022
2021
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Previous Result:
Select Class :
Select One
Eleven
Twelve
Honours
Degree
Mastes
Institute Name :
Board Roll :
Reg. :
Group :
Null
Science
Humanities
Business Studies
Passing Year :
GPA :
Attach Certificate/ Marksheet/ Testimonial/T.C (any One).
Present Address:
House No./Name:
Vill. :
P.O. :
Post Code:
Upazila :
District :
Permanent Address:
If both address are same, Click the check box.
House No./Name :
Vill. :
c
P.O. :
Post Code:
Upazila :
District:
Guardian's Name :
**
Relation With Student :
Father
Mother
Other
Guardian's Contact No. :
**
Guardian's Email :