; t:

. No - 301 Form No. A-l5t-

r-il BANGABANDHU SHEIKH MUJIBUR RAHMAN AGRICULTURAL T]NTVERSITY GaziPur-r706

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W APPLIcATIoNFoRADMISSIoN I

Attach
Graduate Program: MS PhDI I two copies of
photograph
For office use only:
Application No. ..
Date received. ...

Term of admission: Summer Winter Year l I

(Maximum three)
L Applicant's Name (Capital letter) : ...... ...:....

2. Father's name
a
J. Mother's name
4. Date of birth
5. Nationality
6. Marital status : Manied
L Permanent address : Village/Street.. ..

P.O. . ...... Postal Code .

P.S. .. .. District
TelephoneiMobile No. (if any).
8. Present address : Village/Street....
P.O. .

P.S. .. .. District
TelephoneiMobileNo. (if any)....... ...........e-mail, (if any) ....;..............

9. Academic qualifications :

Year of Board/University/ Division/ MarksiGPA obtained Points obtained

Examination (to be filled up by office)
Passing Exam. Institution Class/GPA Total %

SSC/Equivalent

HSC/Equivalent

BS/Equivalent

MS/ Equivalent

Total Points
 10. Whether the applicant is a son/daughter/grandson/granddaughter of a

freedom fighter: Yes

if yes, necessary documents must be attached with the application form.

1 l. Whether the applicant is in-service: Yes

If yes, complete the followings

a. Present position

b. Length of service

c. Nature ofjob
d. Employer :

In-service candidate must enclose a letter from his/her employer stating that he/she will be allowed deputation/leave

for at least 18 or 36 months for MS or PhD, respectively

12. Number of publication (s) (enclose the list)

13.. Previous registration number in BSMRAU (if any)

14. Declaration:

I do hereby declare that: (a) the information mentioned in the application is true, if anything is proved to be false,
my candidature will automatically be cancelled; (b) I will abide by the rules and regulations of the university if
admitted, and (c) I will never take part in any activity subversive of the university, the state or of discipline.

Date Signature of the applicant

For official use only

Selected for admission in the program: MS l-__l PhD l---__l

Department ......

Term: Summer Autumn

Head of the Department Dean, Faculty of Graduate studies

Documents required:
Attested copies of all certificates, two passport size recent photographs, marks sheet, character certificate from head of
the institution last affended, nationality certificate/national ID card and original bank receipt. Additional sheet may be
used if necessary.