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Doctor of Business Administration (DBA) Program

INSTITUTE OF BUSINESS ADMINISTRATION UNIVERSITY OF DHAKA Application for Admission 2013 Instructions
1. 2. 3. 4. 5. 6. 7. 8. After filling in the form, put your signature on the designated places. Attach 2 (two) recent colored Passport Size photos with the application. Do not write anything in the shaded areas designated For Office Use Only. Make a Pay Order / Bank Draft for Tk. 2000.00 payable to DBA, IBA. Attach your research proposal (within 1,500 words) with this application. Submit the filled-in form & the Pay Order /Bank Draft to the DBA Program Office between June 1 and July 1, 2013 (Time: 9:00 am to 6:00 pm except Fridays and public holidays). Add additional paper, if necessary, to complete a section. After submitting this form, collect your Admit Card from DBA Program Office on the assigned delivery date.

Personal Data
Fill applicants name in BLOCK letters. If currently unemployed, provide only one contact address. Name:
First Middle Last/Family

Mothers Name: Father's Name: Date of Birth:

dd

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Nationality: National ID/Passport No: Gender: Currently Employed? Address 1 (Home): Address 2 (Work): Telephone #
Work Home Cell

Male Yes

Female No

Email:

Signature of Applicant

Page 1 of 5

Work Experiences
Give details of all full-time employment, starting from the most recent. SL 1 Organization Position Year(s) of Experience

Total years of experience:

Page 2 of 5

Academic Qualifications
Please list all degrees earned, starting from the most recent. SL 1 Name of the Institution Degree Passing Year

Additional Qualification (Professional/Academic)

SL 1 Name of the Institution Name of the Qualification Program Duration

Page 3 of 5

Achievements, Memberships & Activities

Please list all noteworthy achievements / distinctions / awards, professional / association memberships & voluntary / community activities (in order of perceived importance). SL 1 Achievement/Membership/Activity Organization/Field Year(s)

List of Publications (Books, journal articles, conference papers, etc)

SL 1 Name Details Year Published

Page 4 of 5

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

Date
Signature of the Applicant dd

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Application Fees Payment Information

Pay Order/Bank Draft # Pay Order/Bank Draft # Payable to: Bank: Dated:
dd mm yyyy

DBA, IBA

Name of Applicant (in BLOCK letters)

Signature of Applicant

FOR OFFICE USE ONLY

DBA Institute of Business Administration University of Dhaka (Fall 2013) Photo

Admit No.

Signature of IBA Official

Page 5 of 5