Section - I

Personal Information

Name*

Date of Birth*

(dd/mm/yyyy)

Sex*

Male Female

Address*

City*

State*

Country*

Country of Citizenship

Place of Birth (Country + City)

Passport No.

    Expiry Date :

Telephone

Phone* :   Fax :

E-Mail Address*

Mobile No :

Marital Status*

Married Single

Section - II

Enrollment Level

Select type

Undergraduate Applicant(Bachelors)
Graduate Applicant(Master's)
Doctoral Applicant(Ph.D)

List major subjects/areas of interest
(you may list up to three subject areas in order of priority):

 

USA Canada UK Australia Others

Semester Applying For :*

Sept. - Oct. Jan. - Feb. Mid Year Intake
-Of Which Year (Please Select One) -- 2003 2004 2005 2006

Do you plan to live

On Campus Housing Off Campus Housing

Section - III

Test Score Information

Is English your native Language

yes no

Have you taken IELTS

yes no

If Yes, Score Obtained/Date of the test taken

IELTS Score   Date :

If No , When do you intend to take IELTS

Date :

Section - IV

Education Information(Give the Details Starting from SSC/High School)

Qualification 1

Name of the High School (Full Name)

Year of Passing

High School

Grades (Grade,%,Class)

Qualification 2

Name of the College
(Full Name)

Dates attended (mm/dd/yy)

From : To :

Degree Received

Grades (Grade,%, Class)

Qualification 3

Name of the College
(Full Name)

Dates attended (mm/dd/yy)

From : To :

Degree Received

Grades (Grade,%, Class)

Qualification 4

Name of the College
(Full Name)

Dates attended (mm/dd/yy)

From : To :

Degree Received

Grades (Grade,%, Class)

Section - V

Work Experience (optional)

Employment History