Sheikh Hasina University Netrokona, Bangladesh
Admission Form
Photo
GST Roll: GST Score: Merit Position:
Student ID:
1. Basic Information
Student Name (English) : শিক্ষার্থীর নাম (বাাংলা) :
Session :
Name of Faculty : Name of Degree :
Department :
Name of Hall :
Quota (If Applicable) : 2. Personal Information
Date of Birth : Gender :
Place of Birth : Email Address :
Blood Group : Religion :
Mobile No. : Guardian’s Name :
National ID No./
Birth Reg. No.
: Relationship with
Guardian
:
Nationality : Yearly Income of
Guardian
:
Father’s Name : Mother’s Name :
3. Permanent Address
House/Road/Village: Upazila:
Post Office: District:
4. Present Address
House/Road/Village: Upazila:
Post Office: District:
Sheikh Hasina University Netrokona, Bangladesh
Page 2 of 2 5. Emergency Contact
Name: Relationship:
Address: Mobile No.:
6. Previous Academic Information
Exam Roll Registration
No. Group Board Passing
Year GPA SSC/Eqv.
HSC/Eqv.
SSC Institute Name HSC Institute Name 7. Payment Information
Amount Reference No.
DECLARATION
I hereby declare that the above information is true. I shall abide by the rules and regulations set by the University. I shall accept any decision taken by the University if I am accused of any violation of the University’s rules and regulations.
Signature of Father/Mother/Guardian in case of candidate is under 18 years of age
Signature of candidate & Date
--- THIS PART IS FOR OFFICE USE ONLY
Signature with Seal of Chairman of the Department
Signature with Seal of Dean
Signature with Seal of Hall Authority Signature with Seal of Registrar
