Information for Application form for PEng Registration & RAJUK Enrollment

1 Name

2 IEB M/F No.

3 Academic Qualification
& Passing Year

4 Institution

5 Experience (Minimum
experience 7 years)

6 Designation & 2 years

Responsible Position

7 Contact No.
Land phone:

Cell phone:

8 Email

9 Office Address:

Residential Address:

10 Contact person in case

of emergency

Address:

Cell phone:

Email:

Application Form fees to be paid in cash/PO/DD/bKash (no. 01815 700078) with charge.

Amount Tk.. 4000/- for PEng &

Tk.. 7500/- for RAJUK

Signature