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Executive/ Evening MBA (EMBA) Program

Initials

FACULTY OF BUSINESS STUDIES

JAHANGIRNAGAR UNIVERSITY
SAVAR, DHAKA-1342, BANGLADESH

Application for Admission

Spring -2016

Receipt No.

Admit No.

Instructions
1. After filling in the form, put your signature on the 2 (two) designated places.
2. Include 2 (two) passport size photos (Attested) and attested copies all academic certificates and mark sheets with the application.
3. Do not write anything in the shaded areas designated For Office Use Only.
4. After submitting this form, collect your Admit Card from EMBA Program office at FBS on the assigned delivery date.
Personal Information:

Photo

Fill applicant name in BLOCK letters:

Name:
Mothers Name:
Father's Name:
Date of Birth:

dd

mm

Nationality:

yyyy

Gender:

Address 1:
(Home)

Address 2:

(Work, if any)

Telephone #
Work Experiences:

Work

Email:

Cell phone

Are you employed? (Please tick):


Yes
No
Give details of all full-time employment (if any), starting from the most recent.
Position
Organization
Major Responsibilities
From

Academic Qualifications:

Name of Degree

Up to

Please list all degrees earned, starting from the most recent.
Institution

Passing Year

Area / Major

Class/CGPA

Declaration
The information provided in this application form is true and correct. I accept that Faculty of Business Studies, JU reserves the right to restrict my admission or
cancel my registration at any time if any item of information given by me on this form is found to be materially false or incorrect.

Date:

Signature of Applicant

/
dd

/
mm

yyyy

Application Fees Payment Information, Payable to EMBA, Faculty of Business Studies, JU

Pay Order/Bank Draft #

Bank Name:

Dated:

Name of Applicant (in BLOCK letters)

/
mm

yyyy

Signature of Applicant with date

Executive/ Evening MBA Program


Faculty of Business Studies
Jahangirnagar University

Receipt#

/
dd

For Office Use Only

Photo

Admit#
Signature of EMBA Official with date

Offered areas of specialization [Finance & Banking, Marketing, Accounting & Information Systems, and Human Resource Management] will be allocated based
on applicants merit position in admission-test and their preference.