Admissions Office

Asian University for Women

20/A M.M. Ali Road
Chittagong – 4000, Bangladesh
E-mail: admissions@auw.edu.bd
Web: www.asian-university.org
This form must be completed and sent to the
recruitment coordinator for your country by February 5, 2009
(Bangladesh, Cambodia, India, Nepal, Sri Lanka); and
February 19 for all other countries.

UNDERGRADUATE PROGRAM APPLICATION FORM

The information you provide in this form will be used only for screening your application for an entrance examination and personal interview.

A. PERSONAL DETAILS

1. Name of Applicant ________________________________________________________ Please affix here a passport-

Last /Family First Middle size photograph of the
applicant.
Preferred name, if not first name (choose only one) ___________________

2. Date of Birth ____________________________

Day Month Year

3. Place of Birth: ________________________________________________________

City/Town/Village State/ Province Country

4. Nationality ___________________________________
A second copy of the photo must be
5. Religion (optional) Islam Hinduism Buddhism Christianity attached to the supplementary
Other Identification Form, included with this
application.
6. Ethnicity (optional) ___________________________________________________

7. Current Mailing Address

Address ____________________________________________________________________________________________________
House Number Street Name / Number City/Town/Village

____________________________________________________________________________________________________________
State/Province/District Country Postal Code (if you have one)

Phone Number(s) ______________________________________________________________________________

Fax Numbers ____________________________________ Email Address ___________________________________

If different from above, please give your mailing address for all admissions correspondence.

Mailing address (from ____________ to ____________) ____________________________________________________________

dd/mm/yyyy dd/mm/yyyy House Number Street Name / Number

__________________________________________________________________________________________________________
City/Town/Village State/Province/District Postal Code (if you have one)

Phone Number ______________________________________ Fax number _________________________________________

If your mailing address is a boarding school, include name of school here: __________________________________________

8. Possible area(s) of academic concentration/major(s) ____________________________________________________________

____________________________________________________________
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9. Possible career or professional plans __________________________________________________________________________

B. KNOWLEDGE AND SKILLS

11. Name of secondary school/ Junior College you currently attend (or from which you have graduated):
______________________________________________________________________________________________________________

Date of Entry _______________________________________ Date of Graduation _______________________

Medium of Instruction (English or other language) ___________________________________________________________

Type of School: government private religious other

12. Name of Counselor (optional) ________________________________________________________________________

Counselor’s position (optional) _______________________ Counselor’s email (optional) ______________________________

13. List all other secondary schools, including summer schools as well as summer and other programs, you have attended:

Name of School Location (City, State/Province, Medium of Instruction Years Attended

Postal Code, Country)

14. Secondary School Interruption

If your secondary school was or will be interrupted, check all that apply and provide details in the box below.

did not/will not graduate did/will graduate early did/will graduate late did/will change secondary schools

did/will take time off

Details:

15. If any of the following apply to your secondary school education, please check the appropriate box and provide details on
the lines below or on a separate sheet:

Graduated early Graduated late

_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________

16. List all colleges/universities at which you have taken courses for credit; list names of courses taken and grades earned on a
separate sheet. Please have an official transcript sent from each institution as soon as possible.

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 Name of College/University Location (City, State/Province, Degree Candidate? Dates attended Degrees earned
Postal Code, Country)

_____________________________________ ________________________________ Yes No ______________ _____________

_____________________________________ ________________________________ Yes No ______________ _____________

_____________________________________ ________________________________ Yes No ______________ ______________

17. Current Year Courses

First Term Second Term Third Term

_________________________
_________________________
_________________________
_________________________
_________________________
__________________________________ ____________________________
__________________________________ ____________________________
__________________________________ ____________________________
__________________________________ ____________________________
__________________________________ ____________________________

18. Marks/Grades secured in your previous public/government examination

Name of Examination:________________________________________
(Please attach certified copies of examination/relevant certificates)

Subject Marks (%) / Grades School/State Ranks (if you have any) e.g. 1st,
2nd, 3rd, or 1st Division, 2nd Division, etc.
English
Other Language (specify)
Math
Science
Social Science
Others: (specify) i.
ii.
iii.
iv.
v.

19. Standardized Test Information

SAT I

Date taken/ to be taken Verbal/Critical Reading Score Math Score Writing Score
________________________ __________ __________ __________

SAT Reasoning Tests

Date taken/to be taken Verbal/Critical Reading Score Math Score Writing Score
________________________ __________ __________ __________

SAT Subject Tests

Date taken/to be taken Subject Score

________________________ ____________________ __________

Subject Score
____________________ __________

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 Subject Score
____________________ __________

IB / A-Level Examinations

Date taken/ to be taken Test Score

_______________________ ____________________ __________

Test Score
____________________ __________

Test Score
____________________ __________

Test of English as a Foreign Language

(TOEFL) or Other Exam

Date taken/to be taken Test Score

_______________________ ____________________ __________

20. Computer Literacy

Can you use a computer? Yes No If yes, are you able to use the following?

Word processing good fair do not know

Excel spreadsheet good fair do not know

Internet good fair do not know

21. Awards, Prizes, and Scholarships

Briefly list or describe any awards, prizes, or scholarships that you have received at any time in your life.
_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

22. Extracurricular Activities

Provide details of your other skills/activities outside class (if any) e.g. Sports, Dance, Music, Painting, etc.

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

23. Leadership Positions

(if any) e.g. class monitor, group leader for activities, team leader in Girl Guides, etc

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

24. Community Activities and Service

Have you ever been involved in activities to help people in your community? Yes No

If so, please describe below what you did. e.g. flood relief, local fair, community events, picnics, etc
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______________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________

25. Work Experience

Please list paid jobs you have held during the past three years.

Specific Nature of Work Employer Dates Hours per week

____________________________________ ____________________________________ __________________________ _________

____________________________________ ____________________________________ __________________________ _________

____________________________________ ____________________________________ __________________________ _________

C. FAMILY DETAILS

Please list the adults who have legal rights and responsibilities toward you. If a minor, this is usually one or both biological parents when living. If you
wish, you may list on an attached sheet step-parents and/or other adults with whom you reside, or who otherwise help care for you. You may also list
additional deceased parents.

26. Parents’ Marital Status (relative to each other): Never married Married Widowed Separated
Divorced (date ______________)
dd/mm/yyyy

With whom do you make your permanent home? Both parents Parent/Guardian 1 Parent/Guardian 2 Other

Is Parent/Guardian 2 living? Yes No (Date deceased _____________)

dd/mm/yyyy

27. Parent/Guardian 1: Mother Father Legal guardian Unknown

______________________________ ________________________ ______________________

Last First Middle

Home address if different from yours:

____________________________________________________________

____________________________________________________________

Home phone __________________________________________ E-mail _____________________________________________

Occupation ___________________________________________ Name of employer _________________________________________________

College (if any) _________________________________________________ Degree ___________________________________ Year _________

Graduate school (if any) __________________________________________ Degree ___________________________________ Year _________

28. Parent/Guardian 2: Mother Father Legal guardian Unknown

(if applicable)

________________________ _____________________ ________________

Last First Middle

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Home address if different from yours:

____________________________________________________________

____________________________________________________________

Home phone __________________________________________ E-mail _____________________________________________

Occupation ___________________________________________ Name of employer _________________________________________________

College (if any) _________________________________________________ Degree ___________________________________ Year _________

Graduate school (if any) __________________________________________ Degree ___________________________________ Year _________

29. Siblings (Brother/ Sisters)

Name Age If in school, please specify If working, please give

level/class; If schooling is name of job
complete, then specify
highest educational
attainment

Sisters: ____________________________________ _______ _______________________ _____________________

____________________________________ _______ _______________________ _____________________
____________________________________ _______ _______________________ _____________________

Brothers: ___________________________________ _______ _______________________ _____________________

___________________________________ _______ _______________________ _____________________
___________________________________ _______ _______________________ _____________________
___________________________________ _______ _______________________ _____________________

30. Will you be applying for financial aid? Yes No If yes, please fill out the AUW Financial Aid Application form.

D. PERSONAL ESSAY

This personal statement helps us become acquainted with you in ways different from courses, grades, test scores, and other objective data.
It will demonstrate your ability to organize your thoughts and express yourself. We are looking for an essay that will help us know you
better as a person and as a student. Please write an essay (250 words minimum) on a topic of your choice or on one of the options listed
below.

Please indicate your topic from the choices below:

1. Discuss a personal, local, national, or international issue with special significance for you.
2. Identify a particular person (alive or dead, real or imaginary) and his or her influence on you
3. Describe yourself as your friends would.
4. What are your dreams for the future?
5. Describe a failure in your life and the lessons you learnt from it.
6. Topic of your choice.

Attach your essay to the last page on a separate sheet(s) (same size please). You must put your full name, date of birth, and
name of secondary school on each sheet.

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E. REQUIRED SIGNATURE

I declare that all of the above details provided in this form, including any supplements or supporting materials, are correct to
the best of my knowledge.

__________________________________________________________________________ _____________________
Signature Date

RETURN ADDRESS
Candidates from the countries listed below should send their application forms to the recruitment coordinator in charge of their respective country. All other applicants
should send their forms to the Bangladesh admissions office.

Bangladesh Nepal
Admissions Office, Asian University for Women Anjana Shilpakar
20/A M.M. Ali Road, Chittagong – 4000, Bangladesh 1264 Kathmandu, Nepal
admissions@asian-university.org unjana@gmail.com

Bhutan Pakistan
Ven. Lungtaen Gyatso, Director Brig (R) Abdur Rab, Chief Executive & Director
Institute for Language & Culture Studies Synergy for Health & Education
P.O. Box 158, Semtokha, Thimphu Bhutan FF-2, Block-3, Askari Nazir Apartments
ilcs@druknet.bt 266 Kashmir Road, Rawalpindi, Pakistan
auw.pakistanrecruitment@gmail.com

Cambodia Sri Lanka

Maryann Bylander Prof. A. Navaratnarajah
PEPY, P.O. Box 1235, Phnom Penh, Cambodia Sewa Lanka Tertiary Education Program, Sewa Lanka Foundation
maryann@pepyride.org 432A, First Floor, Colombo Road, Borelesgamuwa, Sri Lanka
anavaloga22@gmail.com

India Vietnam
R. Sarto, Managing Director & CEO Duong Anh Vy
Guardian Management Services – Pvt Ltd Trung tam Nghien cuu va Giao luu Van hoa Giao duc Quoc te
TNSCB Office Complex, Top Floor, South Wing, Thirumangalam Jn Truong Dai hoc Su pham TPHCM
100 Feet Road, Anna Nagar, Chennai 60040, India 280 An Duong Vuong, Quan 5, TP, Ho Chi Minh, Viet Nam
sartorajendran@yahoo.com ciecer@hcm.vnn.vn

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 Admissions Office
Asian University for Women
20/A M.M. Ali Road
Chittagong – 4000, Bangladesh
This form must be completed and submitted with
E-mail: admissions@asian-university.org the Undergraduate Program Application Form.
Web: www.asian-university.org

UNDERGRADUATE SUPPLEMENTARY IDENTIFICATION FORM

The University will sign, stamp and return this form to the applicant if she is selected for the Entrance Test and Personal Interview. The candidate
may then use this form as the ticket or admit card for the test centre. The original must be presented: photocopies will not be accepted.

Name of Candidate: _____________________________________________ Please affix here a passport-

size photograph of the
Country: __________________________ applicant.

Mailing address: _______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

For Office Use Only:

Event Date Centre/Venue

Entrance Test

Personal Interview

The candidate must report to the Supervisor at the test centre 45 minutes before the test begins.

Coordinator's Signature: _______________________________ Date: _______________________