BANGLADESH UNIVERSITY OF ENGINEERING AND TECHNOLOGY, DHAKA
Serial No. of Application Form Roll No. for Admission Test
0400187
APPLICATION FORM
FOR ADMISSION INTO
POSTGRADUATE PROGRAM
For Office Use Semester: October, 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: PG CE PHD
Doctor of Philosophy
Department/Institute : CE
2. Desired Status of Student ship: Part-time
3. Name in Full: UMME SURAYA NASRIN
4. Father's Name: MD.AULAD HOSSAIN
5. Mother's Name: AKTERUN NESA
6. Present Address: House#13, Flat#3A, Road#9, Sector#6, Uttara model
Uttara, Dhaka-1230
7. Permanent Address:Vill: Rudanager,Post : Darshana
District: Chuadanga
8. Phone/Mobile No: 01716780910 9. Email: [email protected]
10. Date of Birth: 31-12-1984 11. Place of Birth: Dhaka
12. Gender: Female 13. Marital Status: Married
14. Nationality: BANGLADESHI 15. Religion: Islam
16. Whether Presently Employed? Yes ( Full-time )
Serial No. of Application Form
Name:UMME SURAYA NASRIN
0400187
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)
S.S.C 2000 Jessore 1999 2000 70 1000
H.S.C 2002 Jessore 2001 2002 70 1000
B.Sc. in civil engineering 2008 KUET 2004 2008 3.12 4
M.Sc in civil (structural) 2024 BUET 2019 2024 3.50 4
18. Experience (at most two):
Duration
Designation Organization Brief Description of Job
From To
ASST.ENGINEER 10/09/2017 30/06/2024 RAJUK STRUCTURAL DESIGN AND ANALYIS
CONSUTANT
02/07/2025 22/04/2025 BEPZA STRUCTURAL DESIN AND ANALYSIS
(STRUCTURAL)
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: Dr. Raquib Ahsan 2. Name: MD. NAHIDUL ISLAM
Address: Department of CE,BUET
Address: UTTARA
BUET,DHAKA
Phone/ Mobile No: +8801789170046 Phone/ Mobile No: 01716383680
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: UMME SURAYA NASRIN
0400187
Applicant's Undertaking
I hereby apply for admission into the PG CE PHD.
I agree to abide by all rules and regulations of the University.
Date: 12-04-2025
UMME SURAYA
NASRIN
(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)
51. No.: 07-0173-375
Khulna University of Engineering & Technology
Bangladesh
.
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Umme Suraya Nasrin
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Bachelor of Science in Civil Engineering
Of«thall 0/it; pjJ~ and W~ 8J~ on de ~ 1.9., 2008.
~/~ 8J~ pjJoint~M 3.12 ina ci?cak0/4.00.
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Controller of Examinations RegIstrar Vice-Chancellor
Date: December 08, 2012
