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Bangladesh Technical Education Board, Dhaka
Admission form for 1st semester students, session ……
(To be filled in by hand, as per the Board's certificate)
Institute code and name: ………………………………………………………………
1. Full name of the candidate:
In Bangla (in clear script) — ………………………………………………………………
In English (in block capitals) — ………………………………………………………………
2. Father's name:
In Bangla (in clear script) — ………………………………………………………………
In English (in block capitals) — ………………………………………………………………
3. Mother's name:
In Bangla (in clear script) — ………………………………………………………………
In English (in block capitals) — ………………………………………………………………
4. Guardian's name (in the father's absence): ……………………………………………………………… Mobile for contact at any time: ………………………………………………………………
5. Present address: ………………………………………………………………
6. Permanent address: ………………………………………………………………
7. Nationality: বাংলাদেশী Date of birth (as per the SSC certificate): ……………………………………………………………… Religion: ………………………………………………………………
8. Name and address of the institution where the SSC/equivalent was passed: ………………………………………………………………
9. Documents submitted:
☑ (a) Original SSC/equivalent marksheet
☑ (b) Photocopy of the testimonial from the head of the last institution
☑ (c) Three attested passport-size colour photographs
10. Undertaking by the applicant:
I hereby undertake that I shall abide by all the rules of this institution and of the Bangladesh Technical Education Board, and that I shall under no circumstances engage in any act contrary to this institution, the Board or the laws of the State.
11. The student's SSC/equivalent examination details:
Roll no.: ……………………………………………………………… Registration no.: ……………………………………………………………… Session: ………………………………………………………………
Year of passing: ……………………………………………………………… GPA obtained: ……………………………………………………………… Board: ………………………………………………………………
12. Name of technology: ……………………………………………………………… Shift: ………………………………………………………………
Admission to the 1st semester is hereby permitted.