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KHULNA UNIVERSITY
Business Administration Discipline
Application Form for Executive MBA Admission One Passport
Session: 2020-2021 (2nd Batch) Size Color Photo
(Taken within last 3
Please read the application guideline thoroughly
before you complete the application form months)
(Please take print on both side of a legal size paper)

For Office Use Only Applicant to fill in

Registration No.: Form No. :

Roll No.: Pay order/ Bank Draft

Admission Test Roll No.:
Date of Admission:

..............................................................................
Signature of the Chairman, Admission Committee Merit Position:
........................................
Signature of the Registrar
Amount Received:

Applicant to fill in

1. Full name in block letters (in English):................................................................................................................................................................

(in Bangla):.................................................................................................................................................................
2. Father’s Name:...........................................................................................................................................................................................................................
3. Mother’s Name:........................................................................................................................................................................................................................
4. Contact: (a) Present Address:..........................................................................................................................................................................................
................................................................................................................................................................................................................

(b) Permanent Address: ...............................................................................................................................................................................

..............................................................................................................................................................................................................

(c) Mobile No.......................................................................................................

(d) Email: …………………………………………………

5. Date of Birth: DD MM YYYY

6. Nationality:.................................................................................................................

.....................................................................................................................................
ADMIT CARD
KHULNA UNIVERSITY Paste Here
Business Administration Discipline
Application Form for Executive MBA Admission
One Passport
Session: 2020-2021 (2nd Batch)
Size Color Photo
For Office Use Only (Taken within last
Form No. 3 months)
Admission Test Roll No.

1. Full Name in Block Letters (in English):____________________________________________________________________________

2. Father’s Name:___________________________________________________________________________________________________________
........................................
Signature of the Applicant
(Please See Overleaf)
7. Educational Qualifications of the Applicant (Complete this section carefully and correctly. This application
will be cancelled if information is incomplete or incorrect):
Year of Division/Class/ Points
Name of the Examination Board/ University
Passing CGPA Obtained
SSC/Equivalent
HSC/Equivalent
Bachelor 2/3/4/5 years (Please Encircle)
Master
Total Points =

9. Date of Graduation: DD MM YYYY ((According to result publication date of transcript/mark sheet)

10. Job Experience (mention your experience of the positions in or above 10th grade in the Government scale or equivalent.
Entrepreneurs or owners of the eligible business firms can also apply):
a) Total duration of job experience or experience as an entrepreneur / or business owner:
Years Months

b) Job Experience (Current + Last 2 jobs) :

i) Organization Position* Date of Joining/ *Date of Current *Yearly
Starting Business Salary Turn Over

* Write entrepreneur / business owner if applicable

ii) Organization Position Date of Joining Date of Consolidated
Leaving the Salary
Job

iii) Organization Position Date of Joining Date of Consolidated

Leaving the Salary
Job

Applicant’s Declaration
The information provided in this application form is true and correct. I accept that Khulna University reserves the right to terminate
my admission at any time if any item of the information given by me is found to be false or incorrect.

I declare that if I get admission in Khulna University:

a) I will abide by all the rules and regulations of the University.
b) During my studentship here, I will comply with any decision of any authority of the University or decisions of any person
authorised by the University.
c) I will comply with any change of rule and ordinance of the University. ...........................................
Signature of the Applicant
For Office Use Only
................................................... ..........................................
Comment of the Medical Officer Signature of the Scrutinizer
Fit/Unfit/Temporarily Unfit
.................................................. ..........................................
Signature of the Medical Officer Signature of the Chairman,
Admission Committee
Instructions for Completing the Application Form
1. Affix two recent passport size photographs on the specified boxes.
2. Attach photocopies of all marks sheets and/or transcripts.
3. Your application must be submitted (or reached) to the office, Head, Business Administration Discipline by
4.00 pm, 31st January 2022.
4. Make sure that you have completed the application form and the admit card properly.
5. Collect the admit card (at the time of submitting application form) without which you will not be allowed
to sit for the Viva-Voce
6. Written test Examination will be held on 4th February 2022 from 10.00 am. To 10.45am.
7. Viva-Voce will be held on11 February 2022 from 10.00 am.