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Roll

OR #

Name

Program

Semester Academic Year As

Undergraduate

Graduate

EEE ADV. English MCM Other

CS SE CIS CSE CSSE

BBA

Fall Spring

Last First Middle

Summer 2 0 1 Freshman Transfer

Arch. COE

MSCS MTel MPH Other

Regular MBA Executive MBA Agribusiness MBA

w h e r e l e a d e r s a r e c r e a t e d

www.aiub.edu

AMERICAN INTERNATIONAL UNIVERSITY-BANGLADESH

ADMISSION FORM

www.aiub.edu

* Admission Test Result is only applicable for the semester applied for

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Passport Size Photo

(Color)Personal Information

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Permanent Address

Male Female

Permanent Present

Date of Birth Blood Group

+ _ ve

Gender

Married SingleMarital Status

Residence Phone Mobile Phone

Nationality

E-mail

Place of Birth

DD MM

City Country

YY

Students Signature Authorized Signature (Office use)

Passport Size Photo

(Color)

AMERICAN INTERNATIONAL UNIVERSITY-BANGLADESH (AIUB)Photo Card (Official Purpose)

ROLL

NAME

Undergraduate

GraduatePRORGAM

EXAM Date Time AM/PM, Campus

Male Female

EEE Adv. English MCM Other

CS SE CIS CSE CSSE

BBA

Arch. COE

MSCS MTel MPH Other

Regular MBA Executive MBA Agribusiness MBA

Apartment Number House/ Holding/ Plot Number Road/ Street Number Road/ Street Name

Area/ Village Post Office City

District Post Code Country

Present Address (If different from above)

Mailing Address

Apartment Number House/ Holding/ Plot Number Road/ Street Number Road/ Street Name

Area/ Village Post Office City

District Post Code Country

American International University Bangladesh (AIUB) is committed to the principles of equal

opportunity and is open to all students with required academic qualifications. There will be no

discrimination on the basis of age, race, gender, religion, nationality, social groups etc.

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Page3Family Information

AMERICAN INTERNATIONAL UNIVERSITY-BANGLADESH (AIUB)

ROLL

NAME

Undergraduate

GraduatePRORGAM

EXAM

Authorized Signature (Office use)

Date Time AM/PM, Campus

Male Female

EEE Adv. English MCM Other

CS SE CIS CSE CSSE

BBA

Arch. COE

MSCS MTel MPH Other

Regular MBA Executive MBA Agribusiness MBA

Fathers Full Name

Mobile No. E-mail

Fathers Occupation

Employer/ Business Name

Nationality

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16

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Mothers Full Name

Mobile No. E-mail

Mothers Occupation

Employer/ Business Name

Nationality19

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22

21

23 24

Guardians Full Name(if different from above)

Mobile No. E-mail

Guardians Occupation

Employer/ Business Name

Nationality

25

26

28

27

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Father Mother GuardianEmergency Contact Person31

< 1,00,000 BDT 1,00,000 BDT 5,00,000 BDT5,00,000 BDT 10,00,000 BDT 10,00,000 BDT 20,00,000 BDT > 20,00,000 BDT

Family Income (Annual)32

Students Source of Financing Parents Guardian Self Scholarship33

Did you appear for AIUB Admission Test before? If yes, Roll Number:YesNo34

Were you admitted into AIUB before? If yes, ID Number:YesNo35

Do you have any siblings currently enrolled at AIUB? If yes, ID Number(s):YesNo36

If yes, the reason for discontinuation:

Name of the Program:

Name of the Instituition:

Did you discontinue any undergraduate/ graduate program in any other private/ public university?

YesNo

37

If yes, attach Medical Records.Are you suffering from any contagious/ infectious diseases? YesNo38

If yes, attach relevant documents.Do you have any physical or mental disability? YesNo39

If yes, attach relevant documents.Have you ever been convicted of any criminal offences? YesNo40

Passport Size Photo

(Color)

ADMISSION EXAM ADMIT CARD

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Campus 1:House # 58/B, Road # 21Kemal Ataturk Avenue, Banani, Dhaka - 1213Ph: 8820865, 9890804, 9894641

Campus 2:House # 82, Road #14, Block-BKemal Ataturk Avenue Banani, Dhaka - 1213Ph: 8815386, 8811749, 9885907

Campus 4:House #55/B, Road # 21Kemal Ataturk Avenue,Banani, Dhaka - 1213Phone: 8814462, 9887934-5, 8816173-4

Campus 5:House #58/B, Road # 21Kemal Ataturk Avenue, Banani, Dhaka - 1213Phone: 9890804, 9894641, 8820865

Campus 7:House # 23, Road # 17Kemal Ataturk Avenue, Banani, Dhaka - 1213Phone: 8814471-3

Bangladesh

Admission Information:

House #83/B, Road # 4

Kemal Ataturk Avenue, Banani, Dhaka - 1213

Phone: 9890415, 8815386, 8811749, 9885907

Ext: 100, 200

Bangladesh

where leaders are created

Application Form Processing fee will be charged at the time of Form Submission

www.aiub.edu

All Rights Reserved

American International Universty-Bangladesh

Things to remember:

Bring your Admit Card

Bring 2B Pencil, Eraser and SharpenerTurn off your mobile during the exam

Calculator is not allowed

Academic Information

Work Experience

Degree

BoardResult/ Grade

Institution

Group Year

Degree

BoardResult/ GradeInstitution

Group Year

Degree

BoardResult/ Grade

Institution

Group Year

Degree

BoardResult/ Grade

Institution

Organization & Address Position/ Title Dates (From - To) Supervisors Name & Phone

Group Year

No Application will be processed unless Completed and Signed by the Applicant.

A Complete Application Package will include:

Completed Application Form

Three (3) Colored Attested Passport Sized Photos

Attested Photocopies of Mark Sheets, Transcripts and Certificates/Testimonials.

Signature of Applicant DD

Date MM YY

I hereby accept that if admitted to AIUB, I will be bound by all the Rules and Regulations of the University and the AIUB Code of

Conduct. I also understand that withholding or providing false information requested in this Application Form will make Me in-

eligible for Admission into AIUB and may even lead to Termination of Enrollment if admitted.

I therefore certify that all the statements provided above are True and Complete to the best of My knowledge.

TOEFLScore Date

IELTSScore Date

SATScore Date

GRE/ GMATScore Date

OTHERSScore Date

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ImportantNote

* Admission Test Result is only applicable for the

semester applied for and cannot be deferred.