Education:

2. Beginning with Matriculation/s5C or equivalent

Mark sheets to be examination (Copy of certiicares dn
enclosed):
SI No.
Examination Year of Subjects Taken Name of Degree/

1. Passing Certificate obtained

MP 1
DENAL I, E NG LISA,
AT,LIFE SCENCE IOH
PHILCALSCTENeE ltict
HS 202DPHySICS, Lolohy
CHEMTSTR
2 tt
13. Examination, if any, which the candidate proposes to take between now and October next, the
passing of which will qualify the candidate for admission to the course applied for:

SI No. Examination Date on which Subjects5 Approximate

examination will take place date of Result

14. Proficiency of Languages:

Languagee Reading Writing Speaking

EN ALT
HTN D1
ENOLiSH
15. Proposed mode of financing study:
(Please put "Tick Mark" as possible)

a Own funds:

b) Scholarship awarded by candidate's own Government:

c) Scholarship to be awarded by Bangladesh Government:

d) Any other (please specify)

Declaration:

1, hereby, declare that particulars given above are true to the best of my knowledge and belief, that I have
made satisfactory arrangements for regular supply of funds for my expenditure in Bangladesh and that
shall return to my country of domicile after completion or discontinuation of studies in Bangladesh.
further declare that I shall abide fully by the rules and regulations of the instltution and any decision e

Authority of the institution to which I may be admitted.

Signature of the Student (below)

Signature of Parent/Legal Guardian (below)