Delta Computer Science College, Rangpur

Application Form Attach recent

(For Online Admission) passport size
color photograph

Please put your

PLEASE FILL UP THE APPLICATION IN CAPITAL LETTER IN OWN HANDWRITING. signature across the
(Except Signature in CAPITAL LETTER) photograph.

1. NAME OF CANDIDATE:

2. FATHER’S NAME:

3. MOTHER’S NAME:

4. GENDER: MALE: FEMALE:

5. DATE OF BIRTH (DD/MM/YYYY)

6. PRESENT ADDRESS: 7. PERMANENT ADDRESS:

8. MOBILE (STUDENT): 9. MOBILE (FATHER):

10. MOBILE (MOTHER): 11. MOBILE (OTHER)

12. EDUCATIONAL QUALIFICATIONS.

ACADEMIC SC HO O L/C O LLEG E NA ME BOARD GROUP PASSING GPA GPA(without
YEAR optional)
SSC

HSC

13. DESIRED DEPARTMENT: BBA: CSE:

14. SSC SUBJECTWISE GPA:

MATH: PHY: CHEM: ENG: ACC: MANG: ECO: STAT:

15. HSC SUBJECTWISE GPA:

MATH: PHY: CHEM: ENG: ACC: MANG: ECO: STAT:

Declaration:

I hereby declare that all the statements made by me in the application form and information sheet are true and
complete to the best of my knowledge and belief and nothing has been concealed or suppressed. I also understand
that in case, any of my statements is found untrue during any stage of admission and thereafter, I shall be
disqualified for the admission applied for and I shall be liable for any penal action.

Signature of the Student with date