ADDENDUM TO QUESTIONNAIRE FOR ADDITIONAL PROCESSING, QUESTION NO. 3, ALL EDUCATIONAL INSTITUTIONS ATTENDED

ADDENDUM TO QUESTIONNAIRE FOR ADDITIONAL PROCESSING,        QUESTION NO. 3, ALL EDUCATIONAL INSTITUTIONS ATTENDED

CASE NUMBER:   xxxxx

IMMIGRANT VISA APPLICANT:  xxxx

DATE OF BIRTH:  13 JUNE 1981

NAMES OF SCHOOL  / COLLEGE(S)               DATES                   DREGREE 

1.   Saleha Govt. Girls High School                  01/1986 – 12/1996              SSC

2.   Sirajgonj Govt. College                             07/1997 – 06/1999             HSC

3.    Sirajgonj Govt. College                            07/2000 – 06/2004              BSS

4.    Sirajgonj Govt. College                           07/2004  - 06/2006             MSS (Political                                                                                                                          Science)

I swear and affirm that all the information provided above is true and correct to the best of my knowledge and belief. I also acknowledge that knowingly and willfully providing any misleading or false statement may result in the permanent refusal of a visa or denial of entry to the United States of America.

____________________________         __________________

Signature of xxxx                                   Date

CASE NUMBER: xxxxx