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Prime Minister Fellowship 2019-20 Application Form

This document is an application form for the Prime Minister Fellowship program for the 2019-20 session. It requests information in several categories, including personal details, expected educational information, academic background, English proficiency, professional experience, and attachments to submit. The form must be completed with mandatory fields marked with a red asterisk. An incomplete form will not be considered a valid application.

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Kalam
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31 views

Prime Minister Fellowship 2019-20 Application Form

This document is an application form for the Prime Minister Fellowship program for the 2019-20 session. It requests information in several categories, including personal details, expected educational information, academic background, English proficiency, professional experience, and attachments to submit. The form must be completed with mandatory fields marked with a red asterisk. An incomplete form will not be considered a valid application.

Uploaded by

Kalam
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Prime Minister Fellowship 2019-20

Application Form
[NB: Fields marked with RED Asterisk (*) are mandatory. An application without any mandatory
will NOT be considered a VALID application.]
Passport Size
Course Applied for:
Photo (2 copies)
Session for which you are applying
(for hard copy
Month: * application
only)
Year: *

Applicant Category: *

1. Applicant’s Personal Information:

Name (in Bangla):*


Name (As in Passport): *
National Identity Number: *
Passport Number: *
Father's Name: *
Father's Name: (in Bangla) *
Mother’s Name: *
Mother’s Name: (in Bangla) *
Date of birth (dd-mm-yyyy): * Day: Month: Year:
Gender:
Present Address:
Mailing Address:
Address Line:
Permanent Address: * Post: PS:
Upazila: District:
Land Phone Number:
Cell Phone Number: *
E-mail Address: *

2. Expected educational information:

Name of the institute/ University: *


Name of the Department: *
Name of the Study Program: *

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Address of the institute/ University: *
Country of the Institute/ University: *
Title of the Research:
Last date of enrollment (dd-MM-yyyy): *
Expected duration of study (In Number of
Year(s)): *
Amount in figure*:
Yearly Tuition Fee as per admission offer letter: Currency*:
(Please mention currency also) *
Amount in words:*
Do you have fulltime unconditional admission
offer letter (Yes or No): *
Memo Number of the Offer Letter (with date):
Have you received any scholarship for the
expected study?
If the answer to the previous question is ‘Yes’,
please mention the details of the scholarship

3. Academic Background (Please provide your most preferred records of Master’s


in case of having more than two Master’s degree.):

Result (mention in
Name of Group/
Institution/Board Passing Year appropriate column)
examination Subject
Division/Class CGPA
S.S.C. or
Out of
Equivalent *
H.S.C.or
Out of
Equivalent *
Bachelor
Out of
Degree *
Master’s
Out of
Degree
2nd Master’s
Out of
Degree

4. English Proficiency Test:


For Which English Proficiency Test do you have a
valid score? (IELTS/ TOEFL iBT) *
Score of the English proficiency test: *
Date of the Test: (dd-mm-yyyy) *

5. Professional Experience:
5.1. Service information:
Name of the Cadre (* for BCS Applicants only):

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Present Designation: (in English)
Present Designation: (in Bangla)
Present Organization/ Office of Posting: (in English)
Present Organization/ Office of Posting: (in Bangla)
Date of joining in First Service (dd-mm-yyyy): *
Order Date of job confirmation (dd-mm-yyyy): *
Please mention your retirement age according to your
service rules (* Mandatory for the applicant category
‘Government Officer NOT belonging to BCS’ )
Service Identity Number(if any):
Name of the First Organization [for applicants NOT
belonging to Government Service]:
Total Job Experience (in number of years) [for
applicants NOT belonging to Government Service] : *

5.2. Service history (Start from the latest, you CANNOT add new row):

From (dd-mm-
Place of posting Designation To (dd-mm-yyyy):
yyyy)

6. Remarks (Please mention below anything you find important that you could not
inform due to the structure of the form):

Attachments: (Please attach in email and with hard copy)


1. Copy of National identity card
2. Copy of all academic certificates
3. Copy of valid English proficiency test certificate
4. Fulltime unconditional admission offer letter
5. Service confirmation letter [Applicable for BCS Officials who have NOT got any
promotion as of date and Government officer NOT belonging to Bangladesh Civil
Service (BCS)]
6. Job experience certificate (Applicable for applicants NOT belonging to Government
Service)
7. Statement of purpose (SoP)

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8. Two copies of recent passport size photo (for hard copy, attach on the first page of
application)

I hereby declare that the information contained in this application is true, correct and complete. I
understand that, any false statement mentioned here will suffice as ground for disqualification
and legal action.

[The section below the following line is required for hard copy ONLY.]

Date: Signature
Applicant’s Name:

Recommendation of the present controlling


authority:

Signature with seal of Controlling Authority

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