Sei sulla pagina 1di 2

DIRECTORATE OF STUDENTS WELFARE, BUET

STUDENTS DATA BASE FORM


Fill in the form with carefully and accurately

S 2 0

Student No

Department

Name (as appears in the certificate)


Nick Name or Known by
Fathers Name (as appears in the certificate)
Mothers Name (as appears in the certificate)
Name of the Adviser
Guardian Income (P.A.)
Tribal

Tick if Appropriate

Army

Navy

Air Force

Foreigner

Students Address
Permanent Address

Post Code

Parents Address

Post Code

Tel No.

Tel No.

Students Mobile Phone No (If any) :


Fathers Mobile Phone No (If any) :
Mothers Mobile Phone No (If any) :
Contact Address of Local Guardian

Tel No.
Mobile Phone No:
Information Regarding Hall Of Residence:
Name of the Hall
Whether resident or attached (strike off as necessary)
If resident: Room No.

Resident
Block

Signature of the Student


Date:

Attached

Records of co-curricular activities:


Game/Activity
Hall

Participated in
Univ.
Natl

Remarks

Athletics
Basketball
Chess
Cricket
Debate
Football
Hockey
Judo/Karate
Recitation
Singing
Speech
Swimming
Table Tennis
Tennis
Volleyball
Other

Signature of the Student with date

Potrebbero piacerti anche