Department of CSE, BUET

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Batch 30 Ongoing

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Application for Admission: IAC

Course Code:

Batch ID:

Course Title:

1. Name:

2. Father Name:

3. Mother Name:

4. Date of Birth(yyyy/mm/dd):

5. Gender:

6. Email Address:

Your Photograph:

Instruction:

Image should be jpg format and 360 pixel width and 400 pixel height.
[Photo can edit here]

7. Present Address:

District:

Thana:

8. Permanent Address:

District:

Thana:

9. Nationality:

10. Telephone:

Home:

Mobile:

11. Emergency Contact Address:

Name:

Address:

Relationship with the applicant:

Telephone/Mobile:

12. Educational Background: (submit attested photocopies of certificates/mark sheets for each)

Degree/Examination	Institution	Major/Group	Division/Grade	Year
S.S.C. or equivalent
H.S.C. or equivalent

13. Are you a university student in the field of CSE/CS/IT/ICT or graduates in the same field?
If Yes, then please write the name of the programming course you have completed. If you have completed multiple courses then enter the best one. If you haven't completed any programming course just left this information blank.

No Yes

Name of the course: Using: Grade:

14. Present Occupation:

Jobholder Student Others

(If you are a jobholder, please write below the name of your organization, designation etc. If you are a student, write the name of the institution, department, course etc.)

15. Skills:

Operating System:

Database:

Programming:

Others:

I agree that withholding information requested in this application or giving false information will make me ineligible for admission. I hereby certify that the above statements are correct and complete to the best of my knowledge. I have read the Information for Admission related to the program and will abide by all the conditions stated therein.