KHANJAHAN ALI COLLEGE OF SCIENCE & TECHNOLOGY
BOYRA, KHULNA
STP Registration Number: STP- KHU-001752
NSDA Student Registration Form
Course:
Select Course
GCL2
CITCL3
CEPL3
Batch:
Date of Enrollment:
Personal Data
Trainee Name in English:
Bangla:
Date of Birth:
Identification Type:
NID
Birth Certificate
Identification Number:
Gender:
Male
Female
Others
Contact Number:
Email ID:
Person With Disability (PWD)?
Yes
No
If 'Yes' Type of Disability:
Permanent Address
Division:
District:
Upazilla:
From:
Rural
Urban
Address:
Present Address
Division:
District:
Upazilla:
Address:
Religion:
Ethnicity:
Educational Qualification:
Marital Status:
Same as Present Address
Household Profile
Father's Name in English:
Bangla:
Mother's Name in English:
Bangla:
Emergency Contact Number:
Number of Family Members:
Source of Family Income:
Monthly Family Income (BDT):
Income per Person per Day (BDT):
Do you have any Bank Account?
Yes
No
If 'Yes' Name of Bank:
Branch of Bank:
Account Number:
Skills, Experiences, Past Employment & Income
Received any skills training in the past?
Yes
No
If 'Yes' Name of Course:
Course Duration (hours):
Training Provider:
Received Certificate?
Yes
No
Employment Status Before Training:
Unemployed
Self Employed
Wage Employed
Nature of Work:
Amount of Monthly Income (BDT):
How did you learn about this training?
Attachment
1) Photograph:
2) CV:
3) NID/ Birth Certificate:
4) Academic Certificate:
Submit