| CLUB: | Rotary Club of Tangail City |
| OCCUPATION: | Business |
| IN DATE: | —————— |
| DOB: | —————— |
| SPOUSE: | —————— |
| ADDRESS: | Shailsho, Barura, Comilla. |
| PHONE: | 01817-581685 |
| E-MAIL: | —————— |
| CLUB: | Rotary Club of Tangail City |
| OCCUPATION: | Business |
| IN DATE: | —————— |
| DOB: | —————— |
| SPOUSE: | —————— |
| ADDRESS: | Shailsho, Barura, Comilla. |
| PHONE: | 01817-581685 |
| E-MAIL: | —————— |