No.
_______________
                                NORTH SOUTH UNIVERSITY
                                          Dhaka, Bangladesh. Fax : 8852016, Tel : 8852000, Ext.- 2020/2021
                                                           Email: eng@northsouth.edu
                                                       APPLICATION FOR ADMISSION
                                                                   MA IN ENGLISH
AREA OF SPECIALIZATION :
           Literature              Language & Linguistics                   TESOL (Teaching English to Speakers of Other Languages)
 APPLICATION FOR ADMISSION ____________                                         Spring (Jan-Apr)                 Summer (May-Aug)   Fall (Sep-Dec)
1.     ______________________________________________________________
            Last Name                                 First Name                                          Middle Name
     Date of Birth ____ / ______ / _______             ____________________                   __________________
                        Day       Month     Year                   Place of Birth                     Citizenship
          Male                Female                           Married              Single                                           Applicant’s
                                                                                                                                      Photo
2 . MAILING ADDRESS :
     _______________________________________                                            _______________________
     House # / Holding #                           Street / Road                             Area / Village / P.S. / City
     ___________________________________________________                                ______________________________
     District / State                              Post Code                                  Country
     Telephone :
                              Home :                           Parent’s Work / Office :                        Other :        .
     Email : ______________________________________________
                                       INSTRUCTIONS / INFORMATION FOR APPLICANTS
a. The application processing fee of Tk. 1000 (US $15.00 for overseas applicants) is non-refundable. The final decision regarding admission will be
   based on the candidate’s academic background. The decision of the North South University (NSU) Admission Committee is final.
b. The complete application package will include (1) completed application form, (2) two attested passport size photos of the applicant, (3) certified
     copies of certificates and transcripts (MA in relevant subjects/Bachelor degree with honors/4-year BA in English, HSC and SSC or equivalent
   examinations).
c. Submit the complete application package to the Department of English, Plot 15, Block B, Bashundhara, Dhaka 1229, Bangladesh.
d.   NSU is committed to the principles of equal opportunity and will be open to all students with required academic qualifications. There will be no
   discrimination on the basis of race, sex, religion, nationality, social grouping, age, etc.
 Do not write in this area
                                                                                         Acceptable __________________________________
                                                                                         Accepted conditionally __________________________
                                                                                         Not accepted __________________________________
                                                                        Page 2
3.   PERMANENT ADDRESS:
     ___________________________________________________                                   ________________________________
     House # / Holding #                     Street / Road                                             Area / Village / P.S. / City
     ___________________________________________________                                   ________________________________
     District / State                        Post Code                                                         Country
     Telephone: ______________________________________________________________________________________________________
                             Home :                      Work / Office :                                    Other :
                .
4.   FATHER’S/HUSBAND’S NAME:
     _______________________________________________________________________________________
           Last Name                                         First Name                                        Middle Name
     ___________________________________________________                                   ________________________________
     House # / Holding #                     Street / Road                                             Area / Village / P.S. / City
     ___________________________________________________                                   ________________________________
     District / State                        Post Code                                                         Country
     Telephone : _________________________________________________________________________________________________________
                             Home :                          Office :                                  Other
     Fax: _______________________________________________                 Email : _____________________________________________________
5.   MOTHER’S NAME:
     __________________________________________________________________________________________________________________
                        Last Name                  First Name                                        Middle Name
6.   List of undergraduate or graduate institutions you have attended. Give exact dates of attendance.
     _________________________________________________________________________________________________________
     College / University                 From (Year)                To (Year)               Degree    Class / GPA
7.   EXPERIENCE : (Professional, Business, Military etc.). Give details of your record since completion of HSC or equivalent
       examinations.
     ______________________________________________________________________________________________________
     Institution / Organization                           Position / Title                             Date
                                                                  Page 3
8.   Have you taken GRE, TOEFL or IELTS?              Yes         No
     If yes, write your score below:
     GRE scores     : _____________________           Date __________________
     TOEFL scores : _____________________             Date __________________
     IELTS scores : _____________________             Date __________________
9.   Are you a dependent?        Yes    No
     Who will pay your tuition fees?         Self                  Father/Husband
                                             Mother                Other
     If Other, please specify:
     Name : _______________________________________________________________________
     Mailing Address: _______________________________________________________________
     _____________________________________________________________________________
     Telephone: ______________________          _____________________       ___________________
                         Home                          Office                      Mobile
     Fax : _________________________________            Email : _____________________________
     Relationship with sponsor: _______________________________________________________
10. Merit Scholarships, other Academic Honors and Awards :
11. Do you have a major handicap?                           Yes        No
     If Yes, describe briefly:
           Instruction:
                 Bring your own pens, pencils, sharpeners, erasers, etc.
                     and be seated on time
                                                             Page 4
12. Have you ever been dismissed, suspended or expelled from any school/college/university?     Yes         No
     If yes, attach a statement giving details.
13. Were you admitted into any academic program of NSU before? Yes             No
     If yes, state ID# and date of admission: _________________________          ____________________
14. FINANCIAL DATA:
     Indicate funds available for expenses during the period you wish to study at North South University.
     a. Estimated total amount in Taka that will be available each year ________________________________________________
     b. Source of finance ________________________________________________________________________ __________
15. I hereby state that if admitted to North South University, I will be bound by the rules and regulations and all laws
    adopted by the Board of Governors, the Administration, and the Faculty of NSU.
     I agree that withholding information requested in this application or giving false information will make me ineligible for
     admission to NSU and liable for dismissal if admitted. I hereby certify that the above statements are correct and
     complete.
        _________________________                                                    ______________________________________
               Date                                                                                Signature
 NO :   __________________________
                                                  APPLICANT’S RECEIPT
   NAME : _______________________________________________________________________
                                                                                                                 Applicant’s
   ADDRESS : ____________________________________________________________________                                  Photo
 ___________________________________________________________________
 ___________________________________________________________________
   PHONE : ________________________________________