Dhaka University of Engineering & Technology, Gazipur

Gazipur-1700

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Application for admission to Post Graduate Program

The completed form should be returned to the Registrar, Dhaka University of Engineering & Technology, Gazipur, Gazipur-1700, Bangladesh.

Session: Reg. No. Student No.

Type or use block capitals throughout. Check or delete where necessary)

Application for admission to Ph.D./ M.Phill./ M.Sc.Engg./ M.Engg. Program

in Department of ............................................................................ Status: Part-time/Full-time

1. Name in full : .....................................................................................................................................

(As per S.S.C Certificate)
2. Father’s Name : .....................................................................................................................................
3. Mother’s Name : .....................................................................................................................................
4. Present Address : .....................................................................................................................................
.....................................................................................................................................
Phone:.....................................................Mobile:..............................................................
Email:...............................................................................................................................
5. Permanent Address : .....................................................................................................................................
.....................................................................................................................................
6. Date of birth : .................../.................../............................................................................................
DD / MM / YYYY
7. Nationality : .....................................................................................................................................
8. Religion : .....................................................................................................................................

9. Sex : Male Female

10. Marital Status : Single Married

11. Academic Records :

(High School and above)

Examination passed Year of passing Board/University CGPA/Class/ University/Institution

/degree awarded Division period attended

Attach certified copies of the Transcript/Mark sheet of all academic qualification with this application.
Contd/2..
 -2-

12. Proposed field of interest (if any) :..............................................................................................................

13. Practical Experience (if any) :

From To Designation Organization Brief
(Month/Year) (Month/Year) description of job

14. Thesis/Publication:
Serial No. Name/Title Date of publication Remarks

15. Name of two referees, at least one of whom have taught you in the Institution last attended
a Name : ........................................................................................................................................
Address : ........................................................................................................................................
Phone : ............................................................. Mobile:...............................................................
Email : ........................................................................................................................................

b Name : ........................................................................................................................................
Address : ........................................................................................................................................
Phone : ............................................................. Mobile:................................................................
Email : ........................................................................................................................................

I hereby apply for admission to the Ph.D./M.Phill./M.Sc.Engg./M.Engg. program in the Department of

................................. of Dhaka University of Engineering & Technology, Gazipur as a full-time/part-time student. I
agree to abide by all the rules and regulations of the University.

Date:................................................ ..................................................
(Signature of the applicant)

Students found to have made false statements or to have presented false evidence of any kind with their
application tender themselves liable for immediate dismissal from the University.