IBA Executive MBA Program
INSTITUTE OF BUSINESS ADMINISTRATION UNIVERSITY OF DHAKAPhoto
Application for AdmissionApplication for Admission
(Fall 2010 Session)(Fall 2010 Session)Instructions
1.
This application form comprises 3 (three) separate pages.
2.
After filling in the form, put your signature on the 4 (four) designated places.
3.
Include 2 (two) recent, color, Passport Size photos with the application.
4.
Do not write anything in the shaded areas designated “For Office Use Only”.
5.
Make a Pay Order / Bank Draft for Tk.1500, payable to “Executive MBA, IBA”.
6.
Submit the filled-in form & the Pay Order /Bank Draft to the Executive MBA Program Office by Wednesday, August 18, 2010
.
7.
After submitting this form, collect your Admit Card from EMBA Program office at IBA on the assigned delivery date
.
Personal Data
Fill applicant name in BLOCK letters. If currently unemployed, provide only one contact address.
Name:
Last/FamilyFirstMiddle
Mother’s Name:
Father's Name:
Date of Birth: / /
dd mm yyyy
Nationality:
Gender: Male FemaleCurrently Employed? Yes NoAddress 1:
(Home)
Address 2:
(Work)
Telephone #
WorkHomeCell phone
Email:
Page 1 of 4
Signature of Applicant
InitialsReceipt No. Admit No.
Work Experience
Give details of all full-time employment, starting from the most
recent
and going back at least 3 (three) years.
PositionOrganizationMajor ResponsibilitiesDates
Total Duration of Full-time Employment:
Years
Months
Academic Qualifications
Please list all degrees earned, starting from the most
recent
.
DegreeInstitutionDateAwardedArea / MajorClass/CGPA
GMAT Information
(if applicable)
Last TestScores:Test Date: / /
dd mm yyyy
Page 2 of 4
Signature of Applicant Signature of Applicant
VerbalQuantitativeTotalRaw Score:
Percentile:
Achievements, Memberships & Activities
Please list all noteworthy achievements / distinctions / awards, professional / association memberships &voluntary / community activities (in order of perceived importance).
Achievement/Membership/ActivityOrganization/FieldDates
Declaration
“The information provided in this application form is true and correct. I accept that IBA reserves the right to restrict my admission or cancel my registration at any time if any item of information given by me onthis form is found to be materially false or incorrect.”
Date:/ /
Signature of Applicant
dd mm yyyy
Application Fees Payment Information
Pay Order/Bank Draft # Payable to “
Executive MBA, IBA
”Bank: Dated:/ /
dd mm yyyy
Name of Applicant (
in BLOCK letters
)
Signature of Applicant
IBA Executive MBA Program
Institute of Business AdministrationUniversity of Dhaka
Admit #
Photo
Page 3 of 4
Search History:
Result 00 of 00
00 results for result for
p.
Notes
Load more
