Pabna University of Science & Technology

Pabna-6600, Bangladesh
Phone: 0731-64876,64890,64986 Website: www.pust.ac.bd

APPLICATION FOR ADMISSION TO MASTERS PROGRAM

For office use
Registration No... Session.............................
Roll No............

1. Program of study:
2. Department:

M.Sc. Engineering
CSE

EEE

3. Proposed Attendance Status:

Attach two copies of

recent passport size
photograph

M. Engineering
ICE

Full Time

Part Time

4. Field of specialization (As per preference):

(1) ..
(2)

(3)

5. Name in full (Capital latter):..

6. Fathers name:
7. Mothers name:...
8. Date of birth:
9. Nationality:..
10. Sex:

Male

11. Marital status:

Female
Single

Married

12. Permanent Address:

14. Mobile No:.

13. Mailing Address:

..
..
..
...

15. E-mail:

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16.Academic Records:(High School And Above)

Examination
Year of
Passed/Degree Degree
Awarded
Awarded

Division/Class/
Grade

Name of the
Institution
Attended

Degree
awarding Board/
University

Subjects
studied

17. Employment Records:

Period From-To

Organization

Position held

Nature of job

18. Recommendations:
Please provide names with address of two persons (at least one from the teachers o the institution last
attended by the applicant) who are requested to submit personal recommendations on behalf of the
application.
(II)
(I)
Name
: .
Name
: .
Position
:.
Position
:.
Address
:
Address :
.
.

19. Declaration:

The information contained in this application is a true, complete and accurate. I agree to abide by
all the rules and regulations of the institute.
Date:..

.
(Signature of the
candidate)

Note: Students found to have made false statement, concealed information, or presented false
evidence of any kind in connection with their application render themselves liable for payment of all
expenses incurred in connection with their admission and face immediate dismissal from the Institute.