MSS in Media & Communication

Application Form

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OFFIC E US E

Application SLNo .
Student ID No
Date Received
Received By

P LEA SE M AIL TO:

Registrar'sOffice

Plot 16 Block B, Aftabuddin Ahmed Road

Bashundhara R/A, Dhaka, Bangladesh

Phone: +88-02-8431645-53, 8432065-76

Fax: +88-02-8431991

E-mail:

Independent University, Bangladesh

Application Form for Admission

(Pleaseprint legiblyin darkink)

1 Academic Plan
Level applying for / Undergraduate
Graduate [ Programme: Masterof ]
Status applying for Regular Non Degree Do you plan to transfer credits in? No Yes (PleasesubmitCreditTransferApplicationform).
Term to begin Autumn Spring Summer 1 Summer 2 Specialsemester(Check anyone.) Year
2 Personal Information
Family Name / Surname / First / OtherName(s)
Mailing address
Postal code / Country
Telephone / Fax
E-mail
Sex Male Female / Date of Birth ( Day/Month/Year) / Marital status Single Married
Citizenship / Native Language
Blood group / Do you have any allergies? Yes No / If Yes, Pleasespecify
Father’s Name / Occupation
Mother’s Name / Occupation
Spouse’s Name( If Married) / Occupation
3 Academic History
Have you ever been enrolled at IUB before? Yes No / Student ID No.(IfYes)
Have you ever been separated from any employment under condition other than honourable ? Yes No / If YES please explain fully. (use a separate sheet)
Have you ever been suspendedor required to withdraw from any school or college ? Yes No
Please provide names of all institutions attended the most recent being on top
Name of the Class Name of the Institution Medium Year(From–To) Division /Grade / CGPA
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TEST RESULTS
TheadmissionscommitteewillconsideryourGMATscorewhenevaluatingyourapplication.IfyourhaveGMATscoreof500, you will be exemptedfromthe admissiontest. Applicantshouldsubmit attested GMAT score.
GRE SCORE:
MONTH YEAR
% % % % VERBALQUANTITATIVE TOTAL ANALYTICALWRITING
4 Career History
Date employed / Company / Position held / Salary

5 Personal Essay (Your answers should be typed anddouble-spaced)

Thisessaysectionoftheapplicationhelpstheadmissionscommitteegettoknowyoubetterasanindividual.Wewanttoadmita diverseandinteresting groupofstudents whowillcontributetoandbenefitfrom theIUB-MBAProgram.Weareinterestedinthe experiences andqualifications thatdistinguishyou fromother applicants.

Please beconcise, but respondas completelyasyou feelnecessary to eachquestion.

1.Evaluate yourself as aleader.Wherehaveyou demonstratedexcellence?(200 words)

2.What doyouconsider to be yourmost importantpersonal and professional accomplishments?Please limit tothree.(400words)

3. Whyare youapplying for IUB-MBAProgram; whatdo you hopetoexperienceand contribute; and what areyour plansand goals afteryou receive your MBA?(600words)

6 Local Guardian’s Information (to be contacted in case of emergency)
Name
Relationship with the student Father Mother Others / If others, specify the relationship
Contact address
E-mail Telephone
7 Financial Guarantor’s Information (All correspondence including academic transcripts will be mailed at the address mentioned here)
PLEASENOTE: Thefinancial guarantormust haveasourceofincome andshould be able to provideproofif requested.
Name
Relationship with the student Father Mother Others / If others, specify the relationship
Occupation
Mailing address (permanent)
Postal Code / Country
Telephone / Fax
E-mail address
I declare that the particulars provided in this application are accurate. I also declarethat I will abide bythe rules and regulations framed by the University authorities.
Signature of Financial Guarantor / Date

Independent University, Bangladesh PageNo.3

8 Student Agreement
IfadmittedI agree:
9Nottoseekanunfairadvantageoverotherstudents,includingbutnotlimitedtogivingorreceivingunauthorizedaidduringcompletionofacademic requirements.
9 Shallnotadoptor encouragetoadoptanyunfairmeansinprosecutionofanypartof academicrequirements.
9 Totruthfullyrepresentfactandselfatalltimes.
9 Torespectthepropertyandpersonalrightsof allmembersof theIUBcommunity.
I certifythatallstatementshereandintheapplicationforadmissiontotheIUBarecorrect.I agreethatalldocumentssubmittedinsupportoftheapplication becomesthepropertyofIndependentUniversity,Bangladesh(IUB).IauthorizetheUniversitytoreleaseinformationfrommyapplicationandsupporting documentstoauthoritiesandorganizationsprovidingfinancialassistance/fellowshiptopermitmebeingconsideredforsuchsupport.
Signature of Applicant / Date

? Check-list (Pleasereadallinformationcarefully)

¾ Please readthe entire formbeforeansweringthe questions.

¾Check,ifyouhaveATTACHED thefollowinginformationwiththe applicationform.Applicanthastoshowalltheoriginalcopiesatthetime ofsubmissionofthe ApplicationFormforAdmission.

•Two sets of copies of your mark-sheet(s)/academic transcript(s), certificate(s),andtestimonial(s)attestedbytherespectiveinstitutionsor issuing authorities. TwosetsofattestedcopiesofyourGREscore(if applicable).

• Threecopiesofattestedpassportsize photographs.

• Onecopyofstatement ofpersonalessay.

•OnecopyofRecommendationLetter,whichshouldcomedirectlyfrom thepresent employerorfromafacultymemberofthelastinstitution attended.

•Ifyouwishtotransfercredits,askforanadditionalApplicationfor CreditTransfer Form.SubmitthisalongwithoriginalOfficialcopies ofacademic transcript(s)anddetailed syllabi ofcourses.

•Financialundertaking(Item#7),whichistobefilledinbytheperson guaranteeingtomeetthe applicant’seducational expensesat IUB.