2
ndConvocation Registration Form Office of the Controller of Examinations
Plot # 16, Road # 106, Gulshan, Dhaka-1212
Full Name (in Block Letter) Student’s ID No.
Department: Program:
Major Area of Study (if any):
Ending Semester & Year:
Father’s Name
(in Block Letter)
: Mother’s Name(in Block Letter)
:Date of Birth: Nationality:
Present Address:
Permanent Address:
Contact No: Emergency Contact No.
E-Mail Address:
ACADEMIC QUALIFICATIONS
Name of the
Exam Name of the Institute Group / Major Result Passing Year
Amount Paid:………...Receipt/Pay order/Bank Draft No……….Name of the Bank………...
Employment Status: (Please put mark) Employed Self-employed Not employed
If employed/ Self-employed: Current Designation:………Name of the Organization & Address:………..
………..
Have you received the Provisional Certificate? Yes No (If yes, Please attach the original Provisional Certificate with this application) Declaration by the Student:
1) I do hereby declaration that the above mentioned information is absolutely correct.
2) I understand that if the university requirements are not fulfilled, I may not be allowed to attend the convocation.
Student’s Signature Signature of authorized official of MIU with seal
BASIC INFORMATION
Photograph
Provisional Certificate may be issued.
Verified by Controller of Examinations
OFFICE CLEARENCE (For Student)
Library Accounts Office Department
Authorized Officer, Library Authorized Officer, Accounts Head of the Department FOR OFFICE USE ONLY
N.B:
Registration Fee: (BDT 7000/- (Take Seven Thousand only) for a single degree or BDT 10000/- (Taka Ten thousand Hundred only) for both Bachelor & Master degrees)
Necessary Documents:
1) 3 copies of attested Passport Size Colored Photographs
2) Copies of all Academic Certificates (SSC, HSC & Graduation) attested by any Faculty Member of MIU 3) Transcripts (for MBA & MA)
4) Original Registration Fee Payment Receipt: Receipt/Pay order/Bank Draft 5) Photocopy of Provisional Certificate (if taken earlier)
6) Provisional Certificate must be surrendered to the office of the Controller of Exam, at the time of receiving the Original Certificate
7) In case of duel degree separate Registration Form must be submitted.
