BANGLADESH UNIVERSITY OF ENGINEERING AND TECHNOLOGY, DHAKA
Serial No. of Application Form Roll No. for Admission Test
0501792
APPLICATION FORM
FOR ADMISSION INTO
POSTGRADUATE PROGRAM
For Office Use Semester: April, 2024
Reg No. Signature:
[Seal]
Student No. Bangladesh University of Engineering and Technology
1. The Degree/ Diploma Program in which you want to apply for: M.Sc.
2. Desired Status of Student ship: Full-time
3. Name in Full: MD. ISRAFIL MIA
4. Father's Name: MD. DULAL HOSSAIN
5. Mother's Name: SHAIDA BEGUM
6. Present Address: Kharma Vatipara, Dewanganj, Jamalpur
7. Permanent Address:Kharma Vatipara, Dewanganj, Jamalpur
8. Phone/Mobile No: 01770099768 9. Email: [email protected]
10. Date of Birth: 12-02-1998 11. Place of Birth: Dewanganj
12. Gender: Male 13. Marital Status: Single
14. Nationality: Bangladeshi 15. Religion: Islam
16. Whether Presently Employed? No
Serial No. of Application Form
Name:MD. ISRAFIL MIA
0501792
17. Academic Records (SSC and above, at most six):
Examination Year Duration % of GPA
Name of Institution, and
Passed or of Marks, Scale
Board/ University From To
Degree Awarded Passing or GPA (if applicable)
SSC 2014 Jamalpur Zilla School, Dhaka 2006 2014 5.00 5.00
HSC 2016 Royal Media College, Dhaka 2014 2016 5.00 5.00
B.Sc. 2023 Sheikh Fazilatunnesa Mujib University 2019 2023 3.82 4.00
18. Experience (at most two):
Duration
Designation Organization Brief Description of Job
From To
--- --- --- --- ---
19. Name of two referees not related to you (at least one of whom must have taught you in the
institution last attended).
1. Name: Ferdaus Anam Jibon 2. Name: Fazle Rabby
Address: Uttara Model Town, Dhaka Address: Sheikher vita, Jamalpur.
Phone/ Mobile No: 01716798120 Phone/ Mobile No: 01675182558
Important
Your admission will be provisional until the authority is satisfied that you possess minimum
requirements for admission according to the decision (if necessary) of the Equivalence Committee of
the University. Your admission will be cancelled if you furnish any wrong information or forged
document(s) and fail to submit any required document(s) within the stipulated time.
Serial No. of Application Form
Name: MD. ISRAFIL MIA
0501792
Applicant's Undertaking
I hereby apply for admission into the M.Sc..
I agree to abide by all rules and regulations of the University.
Date: 13-07-2024
MD. ISRAFIL MIA
(Signature of the Applicant)
For University Use
1. Is equivalence of degree(s) done? Yes No Not required
2. Recommended/ Not recommended for admission as a part-time/ full-time student.
Date:
(Head of the Department/ Director of the Institute)
(Seal)