Admission Test Pass (TP) No.

_______________

North South University

Plot # 15, Block # B, Bashundhara R/A, Dhaka-1229, Bangladesh, Phone: 885-2000 ext. 1166 & 5000, Fax: 885-2016

APPLICATION FOR ADMISSION - UNDERGRADUATE PROGRAMS

North South University (NSU) is committed to the principles of equal opportunity and is open to all students with required academic
qualifications. It does not discriminate between age, race, sex, religion, nationality and social group.
Application for admission in 20________ Spring (Jan-Apr)
1.

Summer (May-Aug)

Fall (Sep-Dec)

Print your name:

First Name

Middle Name

Last Name

Other Name

National ID# ___________________________ (if any)

Date of Birth :
Day
Male

Month
Female

Height ________ meter

Year

Place of Birth

Citizenship

Married
Weight ___________ kg

Please affix two passport

size photographs
here

Single
color of hair ___________________

Identification mark _________________________________________________________________

2.

3.

4.

Fathers Name: ___________________________________

Mothers Name:______________________________________

Occupation: _______________________________________

Occupation: __________________________________________

Designation: ______________________________________

Designation: _________________________________________

Work Address: ____________________________________

Work Address:________________________________________

_____________________________________

________________________________________

Mailing Address :
____________________________
House# / Holding#

__________________________
Street / Road

____________________________________
Area/ Village/ P.S./ City

____________________________
District /State

__________________________
Postal Code

____________________________________
Country

____________________________
Home Phone

__________________________
Parents Work Phone

____________________________________
Other

State in order of Preference the Department or Degree for which you are a candidate.
First ____________________ Second ____________________

Non Degree

INSTRUCTION
a. The application processing fee of Tk. 1000 (US $15.00 for overseas applicants) is nonrefundable. The forms are available at NSU
Accounts Office. You can also download application form from the NSU website: www.northsouth.edu. [payment of Tk 1000 must be
the made with pay order during submission of application form.] A complete application includes: (i) application form (filled out); (ii)
four passport size photographs (attested*); (iii) clean copies of certificates and mark-sheets; (iv) two letters of
recommendation/testimonial from previous institutions and (v) photocopy of National ID Card. (You may submit the ID card within one
year if not available now).
b. The final decision regarding admission is based on the candidate's academic background and performance in the written test.

Photographs should be attested by a gazzetted officer or principal/Head of the Department of the last academic institution attended.
Do not write in this area.
Degree
Non-Degree
Accepted conditionally
Not accepted

5.

Permanent Address:

House# / Holding#

Street / Road

District / State

6.

Area / Village / P.S / City

Postal Code

Country

Who will pay your tuition and other fees?

Self

Father/Husband

Mother

*Other

*Please specify relationship ______________________________________

Name and Address of the Person who will be paying your tuition and fees:
[All your academic records will be released to this person unless advised otherwise in writing]

Name and Designation:

Mailing Address:

Work Phone

Home Phone

7. Do you have a major handicap?

Other

Yes

No

If yes, describe briefly or attach a statement.

8. Have you ever been dismissed, suspended or expelled from any institution of learning?
If yes, describe briefly or attach a statement.

Yes

9. Did you appear at the NSU Admission Test before ?

If yes, state TP# and date of admission test.

Yes

No

10. Were you admitted into NSU before?

If yes, state ID# and date of admission.

Yes

No

11. List the schools, colleges and universities you have attended, with dates of attendance.

No

S.S.C./ Secondary School

Institution

Board/University

From(mm/yy)

To(mm/yy)

Division/Class/GPA/Marks

Board/University

From(mm/yy)

To(mm/yy)

Division/Class/GPA/Marks

Board/University

From(mm/yy)

To(mm/yy)

Division/Class/GPA/Marks

H.S.C./High School /GCE

Institution

College / University
Institution

12. Experience (Professional, Business etc.) Account for all of your time since completion of HSC or equivalent examinations.
Institution / Organization

Position / Title

Dates

13. Merit Scholarships, other Academic Honors and Awards you have received.
14. I hereby accept that if admitted to North South University, I will be bound by the rules and regulations of the

University and the NSU student code of conduct.

I understand that manufacture, distribution, possession and consumption of tobacco products, alcohol, drugs, and
controlled (illegal) substances at NSU premises are strictly prohibited and that I may be expelled for violating the
prohibition or for abetting violations.

I am aware that withholding information requested in this application or giving false information will make me ineligible
for admission into NSU, and will render me liable for dismissal, if admitted. I hereby certify that the above statements are
correct and complete to the best of my knowledge.

Signature of the Person stated in item # 6

Full Name (print)

Note : The application will not be processed unless signed.

Signature of the Applicant

Full Name (print)

Admission Test Pass (TP#) No. __________________________________ (For official use only)

Name: ____________________________________________________________________________

Fathers Name: _____________________________________________________________________

Please affix a
passport size
photograph

Mothers Name: ____________________________________________________________________

here

National ID# ____________________________________ Phone: ___________________________

Identification mark: ___________________________________________________, Color of hair: _________________________

Do not write below the perforation

Admission Test Pass

Instructions (AM)

Please be seated by 8:45 AM.

The test starts at 9.00 A.M

Mobile Phone, Radio Devices, Electronic Dictionary,

and calculators are prohibited.

Bring you own pencils, sharpeners, erasers etc.

Admission Test Pass No.

(For official use only)

Please write your name & address below:

Name : ________________________________________________________________
Address : ______________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

National ID# ______________________________ Phone : _______________________

Please affix
a passport
size
photograph
here