HAJEE MOHAMMAD DANESH SCIENCE AND TECHNOLOGY UNIVERSITY

(HSTU), DINAJPUR
FACULTY OF BUSINESS STUDIES

Program Details: MBA(Evening) 13th Batch, January

January- 2020

Roll No: Photograph

(Passport size)
For Office Use Only

Personal Details:
Name: Date of Birth (dd/mm/yy):
Father’s Name: Male Female
Mother’s Name: Nationality:
Present Address:
House No:
Village: Mobile No:
Post Office: Fax No:
Police Station:
District: E
E-mail:
Permanent Address:
House No: Mobile No:
Village:
Post Office: Fax No:
Police Station: E
E-mail:
District:

Academic and Professional

rofessional Qualifications: (Enclose photocopies of all academic Certificates, Mark sheets (Transcripts)
(Transcripts),,
Testimonial and Other relevant documents)
Certificate/ Year of Division/ Points Obtained
Group/Discipline Institute/ Board
Degree Passing CGPA (Filled by office)

Employment or Professional Records: (only for service holder)

Joining Date Name of institution(s)
nstitution(s) Designation
Employment Status

Particulars of Pay Slip Pay Slip No. Date:

Declaration:
I declare that, the information given in form is true, correct and complete.

Signature ………………………
……………… Date………………
……
After completing the form, please put your signature with date and return it to the Dean, Faculty of Business Studies, Hajee
Mohammad Danesh Science and Technology University, Dinajpur-5200.

HAJEE MOHAMMAD DANESH SCIENCE AND TECHNOLOGY UNIVERSITY (HSTU), DINAJPUR

Faculty of Business Studies
MBA (Evening) January-2020
2020
Admit Card Roll No:
Name :

Father’s Name : Photograph

(Passport size)
Mother’s Name:

……………………...
Applicant’s Signature Member Secretary’s Signature