Institute of Education and Research Khulna University
Application Form for Admission in PGDEd 2019-2020
For Office Use Only
Student No. Form No.:
PGDEd Institute of Education and Research
Admission Test Roll No.
Merit Position Date of Admission
Signature of the Registrar
Applicant to Fill in
1. Applicant’s Name
In Bangla
In English (CAPS)
2. Parents’
Name
Mother Father
3. Present Address
4. Permanent Address
5. Date of Birth:... 6. Mobile Phone Number:...
7. Guardian’s Mobile Phone Number:... (Relation: ………)
Signature of the Applicant Date:...
Institute of Education & Research Khulna University
PGDEd Admission Test 2019-2020
Admit Card
Applicant’s Name
In Bangla
In English (CAPS) Parents’
Name
Mother Father
……….
Signature of the Applicant Date:...
Form No.: PGDEd Roll No.:
One Passport Size Photograph
(Paste here;
don’t staple)
One Passport Size Photograph
(Paste here;
don’t staple)
8. Academic Qualification of the Applicant:
Examination Year of
Passing Board/
University Name of the
Institution CGPA/
Total Marks Percentage of Marks S.S.C /
Equivalent H.S.C / Equivalent Bachelor (Hons.)/
Equivalent Masters/
Equivalent Others
9. Publication(s) if any:
10. Experience in Education sector (please specify):
. . . Signature of the Scrutinizer
Applicant’s Declaration
The information provided in this application form is true and correct. I accept that Khulna University reserves the right to cancel my admission at any time if any aforementioned information is found false or incorrect.
I promise that if I get myself admitted in Khulna University:
a) I will abide by all the rules and regulations of the university.
b) I will comply with any decision of the university or decisions of any person authorized by the university.
c) I will arrange my own boarding when the university cannot provide me with accommodation.
Signature of the Guardian Signature of the Applicant For Office Use
Comment of the Medical Officer:
Fit/Unfit/Temporarily unfit
Signature of the Chairman PGDEd Admission Committee 2019
Signature of the Medical Officer
Instructions for Filling in the Application Form
1. Fill in all the applicable sections of this form. Write N/A for ‘Not Applicable’ sections.
2. Two passport size photographs to be pasted on the specified boxes.
3. The application must be accompanied by attested copies of the following documents:
a) Certificate and Mark Sheet/Grade Sheet/Academic Transcript of SSC,HSC, Bachelor/Equivalent and Masters (if any) examinations;
b) Certificate of work experience in education sector from the controlling authority(mentioning duration of work).
4. Application along with all documents to be submitted to the office room of Institute of Education and Research (1st Floor, Shaheed Syed Nazrul Islam Bhaban), Khulna University, Khulna directly or by post during office hours (9.00AM - 5.00PM) from 28 April, 2019 to 18 June, 2019.
5. Candidates must collect admit card for the admission test from office of the Institute of Education and Research, Khulna University, Khulna-9208.
6. Candidates will have to collect all information regarding admission from the notice board of the Institute of Education and Research, Khulna University, Khulna-9208.
No candidate will be allowed to sit for the admission test without admit card.
