Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Matric No.:
A. PERSONAL DETAILS:
Full Name Fathers Name Mothers Name Guardians Name
( where applicable)
English: Bengali: Occupation: Occupation: Occupation: Month: Year: Marital Status: Single Married Female
Present Address:
Mobile (if any): E-mail: Year of Passing Class/Grade / division/ Marks Obtained
B. ACADEMIC BACKGROUND:
(2)
D. PROFESSIONAL DEGREE/DIPLOMA/TRAINING (if applicable):
Name of awarding institution / body Field/Subject(s) attended Degree/Diploma obtained Grade
E.
F. LANGUAGE PROFICIENCY :
Excellent
(Tick mark where applicable)
Good Arabic
Skills
English
Arabic
Arabic English
Personal income (per annum): Fathers/Guardians income (per annum) : Sponsor: i) Name of the Sponsor: ii) Amount sponsored:
H. REFEREES:
Please give names of two persons who are able to comment on your ability and aptitude for your chosen program of study in the University. 1. Name:... Position: Address: .. . Tel: E-mail: 2. Name:---------------------------------------Position:------------------------------------Address:------------------------------------... ... Tel:------------------------------------------E-mail:
(3)
I. OTHERS:
Do you need the University residential facilities? Yes No If yes; please report to the Students Affairs Division (STAD) of IIUC for necessary arrangement.
J.
DECLARATION:
I do hereby certify that the information provided in this application, are complete and true. I understand that the University has the right to reject this application or cancel my admission if any information provided herein is found false or incorrect. If my application is accepted for admission to the program applied for, I undertake to abide by all the rules and regulations of this University and ensure to pay all fees & charges duly. Date: Applicants Signature
K.
CERTIFICATION BY FATHER/GUARDIAN /SPONSOR (as the case may be): I hereby certify that all the information furnished in this application are complete and true. I understand that if at any time the information or part thereof stated in the declaration is found to be otherwise, the University has the right to disqualify this application or cancel his/her admission. I also hereby declare that I take the full responsibility to bear the expenses to his / her studies at IIUC. Date: Signature of Father/Guardian/ Sponsor
(The Candidate must enclose the following documents with the Admission Form)
Enclosures:
1. Attested true copies of all academic Certificates and Marks Sheet 2. Two copies of stamp size photographs
International Islamic University Chittagong Attach A Stamp size Photograph Admit Card
Semester: Spring Summer Autumn Academic Year: Roll No....................................... Program:.............................................................................. Applicants Name:................................................................................................................................... Date of Admission Test: ............................................................. Time:..................................... Contact Address:......................................................................................................................................
Authorized Signature
(4)
FOR OFFICIAL USE ONLY
Departmental Remarks:
Incomplete Recommended Not Recommended
Complete
Final Approval:
Accepted Remarks (if any): Date: Signature of the Pro Vice-Chancellor
Rejected
Instructions 1. The Candidate must carry the Admit Card during the Admission Test and Viva Voce. 2. It is not transferable. 3. If it is lost before Examination, Please report at ACAD of IIUC immediately.
Academic Affairs Division Permanent Campus: Kumira, Chittagong Chittagong City: 154/A, College Road, Chittagong- 4203, Bangladesh.
Phone: 88-031-610085, 610308, 638657, 617347 Fax: 610307 E-mail: acad@iiuc.ac.bd, Web site: www.iiuc.ac.bd
Dhaka Campus: House# 23, Road # 3, Dhanmondi, Dhaka-1205, Bangladesh. Phone: 88-02-9670220, 8629947, 9670193, 8613294, Fax :8624692,. E-mail: iiuc_acad@yahoo.com