Test Pass (TP) No ______________
MBA
@
North South University
NSU
School of Business
Plot # 15, Block # B, Bashundhara R/A, Dhaka-1229, Bangladesh, Phone: 885-2000, Fax: 885-2016, 884-5165
APPLICATION FOR ADMISSION : MBA PROGRAM
North South University (NSU) is committed to the principles of equal opportunity. Candidates with required
academic qualifications and acceptable performance in the test will be admitted into the program. There will be no
discrimination on the basis of age, race, sex, religion, nationality, social groupings, etc.
Please cross mark (X) the appropriate boxes, where necessary:
Application for admission in:
Spring (Jan Apr)
1.
Summer (May Aug)
Fall (Sep Dec)
Year
(a) Name (in block letters):
_____________
First Name
______________
Middle Name
____________
Last Name
_____________
Other Name
(b) Date of Birth_______ _________ ______ ______________ ___________
Day
Month
Year Place of Birth Citizenship
Please affix
two passport
size
photographs
here
(c) National ID# ______________________________________________________
(d) Gender: Male
2.
Female
(e) Marital status: Married
Single
Mailing Address:
_______________________ ____________________________
House / Apt #
Street/Road
_______________________________
Village & P.S.
_______________________ _____________________________
District/City
Postal Code
_______________________________
Country
INSTRUCTIONS
The application processing fee of Tk.800 (U.S. $20.00 for overseas applicants) is nonrefundable.
Application Forms are available at United Commercial Bank Ltd (UCBL), Bashundhara R/A Branch.
Applications will not be processed without a complete application package which includes (1)
completed application form, (2) one set of all certificates and mark sheets/ transcripts (attested), (3) three
passport size photographs of the applicant, (4) photocopy of National ID Card (You may submit the ID card
within one year if not available now), and (5) Appointment letter and experience certificate (attested), if any.
Decision regarding admissions will be based on the candidates academic background and
performance in the written and oral tests. The decision of the MBA admissions committee shall be final.
Remarks
Please do not write in this area
Degree
Non-Degree
Page 2
Accepted conditionally
Not acceptable
3.
4.
Permanent Address:
_____________________________________________________
House / Apt #
Street/Road
_______________________________
Village & P.S.
_____________________________________________________
District/City
Postal Code
_______________________________
Country
Office / Business Address: __________________________________________________________________
_________________________________________________________________________________________
5.
Telephone:
___________________
Home
______________________
Office
Fax : ______________________________
6.
______________________
Mobile
E-mail : _____________________________
Fathers/Husbands Name: _________________________________________________________________
Fathers/Husbands Occupation & Designation:________________________________________________
Work address: ___________________________________________________________________________
Telephone:
7.
______________________
Home
______________________
Office
______________________
Mobile
Mothers Name: __________________________________________________________________________
Mothers Occupation & Designation: _________________________________________________________
Work address: ___________________________________________________________________________
Telephone:
8.
______________________
Office
______________________
Mobile
List the schools, colleges and universities you attended (start with the latest degree):
Degree /
Exam
9.
______________________
Home
Name of Institution
Have you taken the GMAT/TOEFL/IELTS?
Board/
University/
Country
Yes
Year of
Passing
Group
No
If yes, write your scores below:
GMAT score: _______________________
Date taken ___________________
Class /
Division/
CGPA
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TOEFL score: _______________________
Date taken ___________________
IELTS score: _______________________
10. Who will pay your tuition and fees?
Self
Date taken ___________________
Father/Husband
Mother
Other
If other, please give details of the sponsor below:
Name: ___________________________________________________________________________________
Mailing Address: ___________________________________________________________________________
_________________________________________________________________________________________
Telephone:
______________________
Home
Fax: ______________________________
______________________
Office
______________________
Mobile
E-mail: ____________________________________
Relationship with sponsor: ___________________________________________________________________
11. Work experience (start with most recent organization):
Organization & Address
Instructions:
Please be seated by 8:45 A.M.
The test starts at 9:00 A.M.
Calculators are not allowed.
Position/Title
Supervisors Name &
Telephone
Dates
(From To)
Page 4
Bring your own pens, pencils, sharpeners, erasers, etc.
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12. Do you have a major handicap?
Yes
No
If yes, describe briefly or attach a statement.
...
13. Are you an adibasi?
Yes
No
14. (a) Have you ever been dismissed, suspended or expelled from any academic institution?
Yes
No
If yes, describe briefly or attach a statement.
...
(b) Have you ever been dismissed, suspended or expelled from any business organization?
Yes
No
If yes, describe briefly or attach a statement.
...
15. Were you admitted to any academic program of NSU before? Yes
No
If yes, state ID# and date of admission.
...
16. I hereby accept that if admitted to North South University, I will be bound by the rules and regulations
of the university and the NSU Student Code of Conduct.
I accept that manufacturing, distribution, possession and consumption of tobacco products, alcohol, drugs
and controlled substances are strictly prohibited in NSU premises and that I may be expelled for violating
this rule or for abetting violators.
I agree that withholding information requested in this application or giving false information will make me
ineligible for admission into NSU and liable to be dismissed if admitted. I hereby certify that the above
statements are correct and complete to the best of my knowledge.
_____________________
Date
_____________________________
Signature of Applicant
Note: The application will not be processed unless signed by the applicant.
Admission Test Date:
Test Pass (TP) No. ________________
Please complete the following:
Name: _________________________________________________________
Address: _______________________________________________________
_______________________________________________________________
National ID# ____________________________________________________
Please affix
a passport
size
photograph
here
Page 6
Phone: Home: ____________________Mobile:________________________
