CASR Form 5

MILITARY INSTITUTE OF SCIENCE AND TECHNOLOGY, DHAKA

OFFICE OF THE MEMBER SECRETARY OF
THE COMMITTEE FORADVANCED STUDIES AND RESEARCH
Application for the Approval of Time Extension of Ph.D./M.Phil./M.Sc.Engg./M.Engg. Degree Program
(All the items/sub-items of the following list that are applicable to ones must be mentioned and filled in properly)

Date of Application:

1. Name of the Student: Status: Full Time/ Part Time

Roll No: Session: Apr. 20…. / Oct. 20…
2. Present Address:
Email: Tel No:
3. Name of the Department:
Program (Ph.D./M.Phil./M.Sc.Engg./M.Engg.): Division (if any):
4. Session of First Enrolment in the Program:
5. Name of the Supervisor:
Affiliation:
Email: Tel No:
6. Name of the Co-Supervisor (if any):
Affiliation:
Email: Tel No:
7. Title of the Thesis/Project as Approved by the CASR: (IN BLOCK LETTERS)

8. Thesis/Project Proposal Approved by CASR:

Meeting No: Date: Reference No:
9. BPGS Reference: Date of BPGS Meeting:
10. Academic Progress (Semester-wise)
List of Courses so far Completed with Course No, Course Title, Credit Hour, Grade,
Grade Points and GPA: (To be verified and signed by the Program Coordinator)
(A) Semester-wise course work:
(i) Semester ………………………..
Sl. No. Course No Course Title Credit Grade Grade Point CGPA

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 (ii) Semester ………………………..
Sl. No. Course No Course Title Credit Grade Grade Point CGPA

(iii) Semester ………………………..

Sl. No. Course No Course Title Credit Grade Grade Point CGPA

(iv) Semester ………………………..

Sl. No. Course No Course Title Credit Grade Grade Point CGPA

(v) Semester ………………………..

Sl. No. Course No Course Title Credit Grade Grade Point CGPA

(vi) Semester ………………………..

Sl. No. Course No Course Title Credit Grade Grade Point CGPA

(B) Credits earned so far:

Course-work: Thesis/ Project: Overall CGPA:

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Signature of the Program Coordinator:
Date:
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11. Date of Expiry of Stipulated Time:
12. Details of Previous Extension (if any):
1st extension up to: CASR meeting No.: Date:
2nd extension up to: CASR meeting No.: Date:
13. Duration and Date of Extension Applied for via this Application:
Duration: month(s) / year(s) Extension up to:

14. Justification for Extension of Time by the Student:

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Signature of the Student:
Date:
15. Comments of the Supervisor:

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Signature of the Supervisor:
Date:
16. Comments of the Head of the Department:

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Signature of the Head of the Dept.:
Date:

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