Test Pass (TP) No ______________

MBA
@

North South University

NSU

School of Business
Plot # 15, Block # B, Bashundhara R/A, Dhaka-1229, Bangladesh, Phone: 885-2000, Fax: 885-2016, 884-5165

APPLICATION FOR ADMISSION : MBA PROGRAM

North South University (NSU) is committed to the principles of equal opportunity. Candidates with required
academic qualifications and acceptable performance in the test will be admitted into the program. There will be no
discrimination on the basis of age, race, sex, religion, nationality, social groupings, etc.
Please cross mark (X) the appropriate boxes, where necessary:

Application for admission in:

Spring (Jan Apr)
1.

Summer (May Aug)

Fall (Sep Dec)

Year

(a) Name (in block letters):

_____________
First Name

______________
Middle Name

____________
Last Name

_____________
Other Name

(b) Date of Birth_______ _________ ______ ______________ ___________

Day
Month
Year Place of Birth Citizenship

Please affix
two passport
size
photographs
here

(c) National ID# ______________________________________________________

(d) Gender: Male
2.

Female

(e) Marital status: Married

Single

Mailing Address:
_______________________ ____________________________
House / Apt #
Street/Road

_______________________________
Village & P.S.

_______________________ _____________________________
District/City
Postal Code

_______________________________
Country

INSTRUCTIONS

The application processing fee of Tk.800 (U.S. $20.00 for overseas applicants) is nonrefundable.
Application Forms are available at United Commercial Bank Ltd (UCBL), Bashundhara R/A Branch.

Applications will not be processed without a complete application package which includes (1)
completed application form, (2) one set of all certificates and mark sheets/ transcripts (attested), (3) three
passport size photographs of the applicant, (4) photocopy of National ID Card (You may submit the ID card
within one year if not available now), and (5) Appointment letter and experience certificate (attested), if any.

Decision regarding admissions will be based on the candidates academic background and
performance in the written and oral tests. The decision of the MBA admissions committee shall be final.

Remarks

Please do not write in this area

Degree
Non-Degree

Page 2
Accepted conditionally
Not acceptable
3.

4.

Permanent Address:
_____________________________________________________
House / Apt #
Street/Road

_______________________________
Village & P.S.

_____________________________________________________
District/City
Postal Code

_______________________________
Country

Office / Business Address: __________________________________________________________________

_________________________________________________________________________________________

5.

Telephone:

___________________
Home

______________________
Office

Fax : ______________________________
6.

______________________
Mobile

E-mail : _____________________________

Fathers/Husbands Name: _________________________________________________________________

Fathers/Husbands Occupation & Designation:________________________________________________
Work address: ___________________________________________________________________________
Telephone:

7.

______________________
Home

______________________
Office

______________________
Mobile

Mothers Name: __________________________________________________________________________

Mothers Occupation & Designation: _________________________________________________________
Work address: ___________________________________________________________________________
Telephone:

8.

______________________
Office

______________________
Mobile

List the schools, colleges and universities you attended (start with the latest degree):
Degree /
Exam

9.

______________________
Home

Name of Institution

Have you taken the GMAT/TOEFL/IELTS?

Board/
University/
Country

Yes

Year of
Passing

Group

No

If yes, write your scores below:

GMAT score: _______________________

Date taken ___________________

Class /
Division/
CGPA

Page 3
TOEFL score: _______________________

Date taken ___________________

IELTS score: _______________________

10. Who will pay your tuition and fees?
Self

Date taken ___________________

Father/Husband

Mother

Other

If other, please give details of the sponsor below:

Name: ___________________________________________________________________________________
Mailing Address: ___________________________________________________________________________
_________________________________________________________________________________________
Telephone:

______________________
Home

Fax: ______________________________

______________________
Office

______________________
Mobile

E-mail: ____________________________________

Relationship with sponsor: ___________________________________________________________________

11. Work experience (start with most recent organization):
Organization & Address

Instructions:

Please be seated by 8:45 A.M.

The test starts at 9:00 A.M.

Calculators are not allowed.

Position/Title

Supervisors Name &

Telephone

Dates
(From To)

Page 4

Bring your own pens, pencils, sharpeners, erasers, etc.

Page 5
12. Do you have a major handicap?

Yes

No

If yes, describe briefly or attach a statement.

...
13. Are you an adibasi?

Yes

No

14. (a) Have you ever been dismissed, suspended or expelled from any academic institution?
Yes

No

If yes, describe briefly or attach a statement.

...
(b) Have you ever been dismissed, suspended or expelled from any business organization?
Yes

No

If yes, describe briefly or attach a statement.

...
15. Were you admitted to any academic program of NSU before? Yes

No

If yes, state ID# and date of admission.

...
16. I hereby accept that if admitted to North South University, I will be bound by the rules and regulations
of the university and the NSU Student Code of Conduct.

I accept that manufacturing, distribution, possession and consumption of tobacco products, alcohol, drugs
and controlled substances are strictly prohibited in NSU premises and that I may be expelled for violating
this rule or for abetting violators.
I agree that withholding information requested in this application or giving false information will make me
ineligible for admission into NSU and liable to be dismissed if admitted. I hereby certify that the above
statements are correct and complete to the best of my knowledge.

_____________________
Date

_____________________________
Signature of Applicant

Note: The application will not be processed unless signed by the applicant.

Admission Test Date:

Test Pass (TP) No. ________________

Please complete the following:

Name: _________________________________________________________
Address: _______________________________________________________
_______________________________________________________________
National ID# ____________________________________________________

Please affix
a passport
size
photograph
here

Page 6
Phone: Home: ____________________Mobile:________________________