Dhaka University of Engineering & Technology, Gazipur i Gazipur-1700 Photo Application for admission to Post Graduate Program ‘The completed form shouldbe returned tothe Registrar, Dhaka University of Engineering & Technology, Gazipur, Gatiur-1700, Bangladesh, Session: [ J Reg. No. [ ] Student No. [ ] Type or use block capitals throughout. Check or delete where necessary) Application for admission to M Engg./M Sc Engg./M Phil/Ph D Program in Department of .. Status: Part-time/Full-time 1. Name in full (As per SSC Certificate) Father's Name Mother's Name Present Address. Email: 5. Permanent Address... 6. Date of birth 7. Nationality Religion . tial ta sesestnte Sex :O Male OD Female 10, Marital Status :O Single 0 Married 11, Academic Records :8 (High School and above) Examination passed | Year of passing Board/University | CGPA/Ciass/ University/Institution [degree awarded Division period attended ‘Attach certified copies of the Transcript/Mark sheet of all academic qualification with this application. Conta/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, atleast one of whom have aught you inthe Instituon lat attended a Name: Address Phone Emall b Name Address Phone Email T hereby apply for admission to the M Engg./M Sc Engg./M Phil /Ph D program in the Department of fi sven 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: Gignature of the applicant) Students found to have made false statements or to have presented false evidence of any kind with their pplication tender themselves liable for immadiate dismissal from the University.TO BE FILLED IN BY CANDIDATES IN EMPLOYMENT Name of Employer Address, STATEMENT FROM THE EMPLOYER/HEAD OF THE OFFICE MrJ/Miss./Mrs/Ms, Designation an applicant for admission to M Engg./M Se Engg/M Phil/Ph D programm: (name of programme) of Dhaka University of Engineering & Technology, Gazipur is employed in my office. | have no objection to his/her enrolment as a full-time/part-time student. If selected for admission, he/she willjvill not be on deputation while pursuing the course. He/She will be accorded necessary leave/recess to facilitate his/her study at DUET. Gi Date Name id of the office) ignature of the Designation Official Seal