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Institute of Information Technology(IIT)

University of Dhaka (DU)


Affix a passport
Application form for size photo
Master in Information Technology (MIT)
Admission Test (Session - 2011-2012)
Serial No-
Name of the Applicant
1. (BLOCK LETTERS) :
2. Father's Name :
3. Mother's Name :
4. Mailing Address :
Tel
5. Permanent Address :
Tel
6. Date of Birth :
7. Nationality :
8. Academic Career: : [ Must be less than 40 Years on 1/1/2011]

Examination School/College and Board Group Year Marks Division


obtained
SSC/O-Level
HSC/A-Level

Examination Department and University Year Marks Class/Grade


obtained (%)
Bachelor

Master
PGDIT
OTHERS

The information provided in this application form is true and correct. I accept that IIT reserves the right to
cancel my admission at any time if any item of information given by me on this form is found to be materially
false or incorrect.

Date:........................................................ ....................................................................
Signature of the Applicant

1. Attach attested copies of all Marksheets and Certificates.


Institute of Information Technology(IIT)
University of Dhaka (DU)
Affix a passport
Student Identification Card size photo
Master in Information Technology (MIT)
Admission Test (Session - 2011-2012)
Serial No:

1. Name of the Applicant :

2. Father's Name :
3. Mother's Name :

4. Mailing Address :

5. Signature of the Applicant :

Office Seal ______________________________


Signature of the Director

Institute of Information Technology(IIT)


University of Dhaka (DU)
Affix a passport
Admit Card size photo
Master in Information Technology (MIT)
Admission Test (Session - 2011-2012)
Serial No:

1. Name of the Applicant :

Office Seal ______________________________


Signature of the Director

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