Admission Form No:

Student ID No.#

Passport Size Photo *

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City Campus: 13/A, Panthapath, Dhaka-1215, Bangladesh.

Permanent Campus: Khagan, Birulia, Savar, Dhaka-1216

Application For Admission

City University is committed to offer quality education to all students with required academic qualifications.There will be no discrimination on the basis of age, sex, religion, nationality etc.

INSTRUCTIONS

a. The application processing fee (TK 300) is non refundable. The final decision regarding admission will be based on the candidate's academic background and performance in the admission test. The decision of the Admission Committee shall be final. b. Applications will not be processed without a complete application package which includes (1) Duly filled application form, (2) Four (4) passport size recent colour photographs of the applicant, (3) two (2) sets of all certificates and mark sheets/ transcripts (attested). In addition for graduate students two letters of recommendation from teachers/employers are required.

(Put tick mark in the appropriate boxes where necessary)

Campus *

City Campus Permanent Campus

Academic Year

Semester

Spring Summer Fall

Application For Admission In. *

Shift of the Program *

Other

Name: (In Capital Letters) *

Date of Birth *

Place of Birth

Citizenship

Sex *

Male Female

Marital Status *

Single Married

Present Address( In Capital Letter): *

Permanent Address(In Capital Letter): *

Mobile *

E-mail *

Office/Business Address:(If Applicable, for evening program)

Father/Husband's Name: *

Mother Name: *

Father/Guardian's Occupation:

Telephone

Mobile

E-mail

Name of Local Guardian/Contact Person (if not living with Parents)

Address With Mobile Number

Academic Qualification:

Exam/ Certificate *

Name of Institution

Board/University/Country

Year of Passing

Group

GPA

Approximate annual income of your parents/guardian:

Source of income:

Employment Business Property Other

Are you dependent ?

Yes No

Who will pay your tuition and other fees?

Annual income of payer

If other, then specify:

Work Experience:(only for evening program)

Position/ Title

Date

Organization

Address and Telephone

Please give two(2) References: Teachers / Personally know

Name and Designation

Address

Telephone

Declaration

I do hereby swear that if admitted to City University, I will be bound by the rules and regulations of the university and the CU Student Code of Conduct.

I accept that possession and consumption of tobacco products, alcohol. drugs and controlled substances, eve teasing are strictly prohibited in CU premises and that I may be expelled for violating this rule or for abetting violators.

I hereby certify that above statements are correct and complete to the best of my knowledge. I am aware that providing any false information will make me liable for cancellation of my admission.

Admission Date

Signature of Applicant

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Note: The application will not be processed unless signed.

Online Admission Form

Application For Admission

Academic Qualification:

Declaration