Applying for

Chittagong Independent University

Chittagong Independent University

Minhaj Complex 12, Jamal Khan Road, Chittagong-4000

Phone: +88-031-622946, 611262, 636484. Fax: +88-611263

Section: 1
Position applied for:* Candidate's Name:*
Father's Name:* Mother's Name:*
Date of Birth:* National ID Number:*
Present Address:* Permanent Address:*
Telephone Number:* Email Address:*
Section: 2
Education
Examination School/College/University & their locations Division/Class/CGPA Year of Graduation
SSC/O-Level/Equivalent:*
HSC/A-Level/Equivalent:*
Bachelor's Degree Major in:*
Master's Degree Major in:
2nd Master's Degree Major in:
PhD in:
Others, if any:
Section: 3
Publications
Book
Title Name of Publisher Place of Publication Year
Article
Title of the Article(s) Name of Journal Vol.-No. Year
Conference Proceedings
Title of the Paper Presented Conference Organizer Venue Details Year
Research Information
Title of Research Work Name of Supervisor, Designation & Office Address/Sponsor Year
Section: 4
Referees (Please give names and contact details of 2 referees who shall be able to write about your skills, one of whom may be your relative and another one may be your colleague or supervisor):
Reference Name* Reference Address* Reference Telephone No.* Reference E-mail Address*
Section: 5
Work Experience, if any (Most recent 3 jobs)
Institution Name Institution Address Designation Duration
Section: 6
Attachments (.jpg, .jpeg, .png, .pdf)
SSC Certificate:* PhD Certificate:
HSC Certificate:* A Recent Photograph:*
Bachelor's Certificate:* Copy of NID:*
First Master's Certificate: Signature:*
Second Master's Certificate: NOC/Release Letter/Clearance Certificate: