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IUB
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Admissions & Financial Aid Office Block-B, Plot-16 Aftabuddin Ahmed Road Bashundhara, Dhaka 1229 G.P.O BOX- 138 Tel: 8401645-53, 8402065-76, Ext: 269, 378, Fax: 840 1991 E-mail: admissions@iub.edu.bd, Web: www.iub.edu.bd
1 Academic Plan
Status applying for Term to begin Intended Major Regular Autumn Non Degree Do you plan to transfer credits in? Spring Summer Special semester No
(Check
Year______________
2 Personal Information
Family Name / Surname Mailing address First / Other Name(s)
Country Fax
Marital status
Single
Married
No
3 Academic History
Have you ever been enrolled at IUB before? Yes No
Have you ever been separated from any employment under condition other than honourable ? 1 Have you ever been suspended or required to withdraw from any school or college ? 1
Please provide names of all degrees completed the most recent being on top Name of the degree HSC SSC
Code for groups : Code for boards : 1= Science, 2= Arts, 3= Commerce & 4=Other 1= Dhaka, 2= Rajshahi, 3= Chittagong, 4=Comilla, 5= Jessore, 6= Khulna, 7= Sylhet
Group
Board
Year
Grade / GPA
Subject
Grade
Year
A level
O Level
Others
4a Please provide the information about your parents & spouse ( if married )
Fathers Name Mothers Name Spouses Name ( If Married ) Occupation Occupation Occupation Highest Educational level achieved Highest Educational level achieved Highest Educational level achieved
1. 2. 3. 4.
ID:
5 What was the most important source of information about IUB? ( please only one )
1
Family members
2
Newspaper (Please specify the name)
3
Teacher
4
Friend
5
Website
6
Others (Specify)
Scale 1- 5
1 1 1 1 1 1 1 2 2 2 2 2 2 2 3 3 3 3 3 3 3 4 4 4 4 4 4 4 5 5 5 5 5 5 5
Country Fax
I declare that the particulars provided in this application are accurate. I also declare that I will abide by the rules and regulations framed by the University authorities. Signature of Financial Guarantor Date
10 Student Agreement
If admitted I agree: Not to seek an unfair advantage over other students, including but not limited to giving or receiving unauthorized aid during completion of academic requirements. Shall not adopt or encourage to adopt any unfair means in prosecution of any part of academic requirements. To truthfully represent fact and self at all times. To respect the property and personal rights of all members of the IUB community. I certify that all statements here and in the application for admission to the IUB are correct. I agree that all documents submitted in support of the application becomes the property of Independent University, Bangladesh (IUB). I authorize the University to release information from my application and supporting documents to authorities and organizations providing financial assistance/fellowship to permit me being considered for such support. Signature of Applicant Date