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HAMDARD UNIVERSITY BANGLADESH
Newtown, Megnaghat, Sonargaon
Contact Address Hamdard Bhaban, 99 Bir Uttam C. R. Datta Sarak, Dhaka-1205
Tel: 9665965, 9665966, 8625194, 8627003 Fax: 880-2-8616958
Email: www.hamdarduniversitybd@yahoo.com, Web: www.hamdarduniversitybd.com
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Application for Admission
Serial No.
Matric No.
Application for Admission :
Spring (March-Aug)
Department:
Autumn (Sept-Feb)
Programme:
Year:
A. Student’s Details
1.
Name:
..........................
................................
Middle Name
First Name
...........................
Last Name
2.
Father’s Name: ............................................................................................................... Profession: ...........................................
3.
Mother’s Name: ..................................................................................................... Profession: ...........................................
4.
Date of Birth: Day ............................. Month ............................................................. Year ...............................................
5.
Place of Birth: .........................................................................................................................................................................................
6.
Citizenship: ...............................................................................................................................................................................................
7.
Sex:
9.
E-mail Address:
Male
Female
National ID No. : ..........................................................
10. Present Address:
Tel (Cell):
Tel (Res/Off):
11. Permanent Address:
Tel (Cell):
Tel (Res/Off):
12. Local Guardian’s Information:
Name:
Official Use Only
Address:
Tel (Cell):
Tel (Res/Off):
Enrolment date:
Batch:
ID Number:
Note: Incomplete Application will not be proceeded
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B. Previous Qualifications
Examination
Subject/Group
Name of the Institution
Board/University
Year
Grade
Division/CGPA
S.S.C or Equivalent
H.S.C or Equivalent
Bachelor
Masters
Diploma
Others
* Use additional sheet if necessary
C. Professional Degree/Diploma/Training (if applicable) ?
Name of awarding Institution/ body
Field/Subject(s) attended
Degree/Diploma obtained
D. Have you got admitted in any other Institution before ?
Yes
Grade
No
* If Yes,
a) Name of the Institution :
b) Courses completed :
c) Grade obtained :
(Note: Please attach official transcripts)
E. Program of study applied for : (From the Prospectus; in difficulty consult the Admission Officer.)
1st Choice :
2nd Choice :
3rd Choice :
F.
Employment Records (if applicable) :
Name and address of employer
Date of employment
Position held
Responsibilities
2
G. Language Proficiency :
Skills
√ (Tick mark where
applicable)
Excellent
English
Others
Very Good
English
Good
Others
English
Fair
Others
English
Others
Reading
Writing
Speaking
Understanding
H. Financial Information:
Source of financial support :
Self
a. Personal income (per annum):
Father’s/Guardian’s
b.
Father’s/Guardian’s income (per annum):
c.
Sponsor:
Sponsor’s
i) Name & Address:
ii) Amount sponsored:
I.
Referees:
please mention names of two persons who are able to comment on your ability and
aptitude for your chosen program of study in the Univrsity.
J.
1. Name: .......................................................................................
2. Name: .......................................................................................
Position: .................................................................................
Position: .................................................................................
Address: .................................................................................
Address: .................................................................................
..........................................................................................................
...........................................................................................................
Tel: ................................................................................................
Tel: ................................................................................................
E-mail:
E-mail:
Others:
Do you need the University residential facilities?
Yes
No
If yes; please report to the Students Affairs Division (STAD) of HUB for necessary
arrangement.
K. Declaration :
I do hereby certify that the information provided in this application, is complete and
true. I understand that the university possesses 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 will abide by all
the rules and regulations of this University and pay all fees & charges duly.
Date:
Applicant’s Signature
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L. Certification By Father/Guardian/Sponsor ( as the case may be):
I hereby certify that all the information furnished in this application is 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 will take the full
responsibility to bear the expenses to his/her studies at HUB.
Date:
Signature of Father/Guardian/Sponsor
Enclosures : (The candidate must enclose the following documents with the Admission Form)
1. Attested true copies of all acadamic Certificates and Marks Sheet
2. Two copies of National ID Card/Passport and two copies of stamp size photographs
N.B : Incomplete application will not be considered for admission.
(Perforation ........................................................................................................................................................................)
For Official Use Only
Academic Affairs Division:
Application From:
Complete
Departmental Remarks:
Incomplete
Recommended
Not Recommended
Remarks (if any):
Authorized Signature of ACAD
Signature of the Head of the Department
Final Approval
Accepted
Rejected
Remarks (if any):
Date:
Signature of the Pro Vice-Chancellor
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