Application Serial No.

: Date: / /
(to be given by the office)

Application to the Board of Undergraduate Studies, CSE

1. Student No: .................................... 2. Name: ..........................................................................
3. Current Level-Term....................... 4. Name of advisor: ........................................................
5. Total credit hours completed/earned: ........................ 6. Current CGPA: ................................
7. Total credit hours required/remaining for graduation: .............................................................
8. Application for (Put tick marks; Put multiple ticks if applicable and clearly describe your
case in #11): Self-Study Regular Special Course Term-extension Others
9. Detailed Comments/description from the student (Provide supporting documents from BIIS
including a consolidated/ all grade-sheets)

10. Signature of the student with date:

11. Forwarding/Comment and signature of the honourable Advisor (Please verify the
information provided by the student before forwarding and please do not forward if the
supporting documents are missing):

12. Decision at BUGS or by Head, CSE with details:

Department of CSE, BUET, ECE Building, West Palasi, Dhaka-1205, Bangladesh