Jagannath University |

Applicant's Information

Name (in Block Letters) *

Mother's Name *

Father's Name *

Phone: *

E-mail:

Permanent Address

Care of

Village/Town/Road/House/Flat *

District *

P.S/Upazila *

Post Office *

Post Code

Present Address Same as Present Address

Care of

Village/Town/Road/House/Flat *

District *

P.S/Upazila *

Post Office *

Post Code

Date of Birth (dd/mm/yyyy): *

Gender: *

Nationality: *

Academic Records

Exam. *	Year of passing *	Roll No. *	Board *	Result Type *	Result *

Bachelor's Degree/Equivalent

Exam. *
Subject/Degree *
University/Institute *
Year of passing *

Result Type *
Result *
Course Duration *

Master's Degree/Equivalent

If applicable

Exam.
Subject/Degree
University/Institute
Year of passing

Result Type
Result
Course Duration

Candidate Photo *
(Photo Dimension : 300X300 px. Only JPEG,PNG are allowed)

Candidate Signature *
(Signature Dimension : 300X80 px. Only JPEG,PNG are allowed)

* I certify that all the above mentioned information in the form is correct. In case of any fraudulent data Jagannath university reserves the right to cancel the admission at any time.