Rajuk Uttara Model College

Admission Form (Class VI & IX)
	Click Here to Download Admission Instruction Fields marked with asterisk (*) are mandatory

Admission Information

Admission Circular :		Select Class
The Class in Which Admission is Sought :	*	Select Class
Group :
Version :	*	Select Version
Shift :	*	Select Shift
Lottery User ID:	*	Enter Lottery User ID

Applicant’s information

Name in Bangla :	*	Enter Your Name In Bangla Please Maximum 150 characters allowed.
Name in English :	*	Enter Your Name In English Please Maximum 150 characters allowed.
Sur Name :	*	Enter Your Sur Name Please Maximum 150 characters allowed.
Online Verified Birth Reg. Number :	* (Copy/Paste not allowed. Please enter using keyboard.)	Enter Your Birth CertNo Please Birth CertNo must be 17 digits.
Date of Birth :	Day: Month: Year: * (According to the Birth Certificate.)	Select Day Select Month *Select Year
Blood Group :	* Select Your Blood Group Please	Nationality :
Gender :	*	Religion : *
	Select Your Gender Please	Select Your Religion Please

Academic Information

Class :
Last Class Attended :	*	Enter Last Class Name
Name of the Institution :	*	Enter Name of the Institution
Institution Address:	*	Enter Institution Address
Education Board:	*
Passing Year:	*
Registration Number:	*
GPA:	*

Father’s INFORMATION

Father's Name In Bangla:	*	Enter Father's Name In Bangla Maximum 150 characters allowed.
Father's Name In English :	*	Enter Father's Name In English Maximum 150 characters allowed.
Educational Qualification:	*	Select Qualification
Father's Occupation :	*	Select Occupation
Organization :	*	Enter Appointment & Organization
Designation :	*	Enter Designation
Yearly Income :	*	Enter Yearly Income
Father's Mobile Number :	*	Enter Father's Mobile Number
Office Tel :
Father's NID Number :	*	Enter Father's NID Number
E-TIN Number :

Mother’s INFORMATION

Mother's Name In Bangla:	*	Enter Mother's Name In Bangla Maximum 150 characters allowed.
Mother's Name In English :	*	Please Mother's Name In English Maximum 150 characters allowed.
Educational Qualification:	*	Select Qualification
Mother's Occupation :	*	Select Occupation
Organization :	*
Designation :	*
Yearly Income :	*
Mother's Mobile Number :	*	Enter Mother's Mobile Number
Office Tel :
Mother's NID Number :	*	Enter Mother's NID Number
E-TIN Number :

GUARDIAN'S INFORMATION IN ABSENCE OF PARENTS

Guardian's Name In Bangla:

Enter Guardian's Name In Bangla

Guardian's Name in English :

Enter Guardian's Name in English

Educational Qualification:

Select Qualification

Guardian's Occupation :

Select Occupation

Organization :

Designation :

Guardian's Mobile Number :

Enter Mobile Number

Yearly Income :

Guardian's NID Number :

Enter Guardian's NID Number

E-TIN Number :

Relation With Student :

Enter Relation With Student

Guardian's Address :

Enter Address

Catchment/Quota INFORMATION

Catchment Area (Only applicable for those applicants who lives at Uttara East & Uttara West Thana)

Quota :

N/A

(FQ: Quota for children/Grandchildren of freedom fighters.)

Only for Applicant's Brother / Sister Currently Studying at Rajuk College

(If Applicant's Brother / Sister Currently Studying at Rajuk College then click "Check College No.". Otherwise Skip.)

INFORMATION OF TWIN(S)

(যমজ ভাইবোন উভয়েই আবেদনকারী হলে প্রত্যেক আবেদনকারীকেই এটি নির্বাচন করতে হবে।)
Do you have Twin(s)? :	*	Select YES or NO

(All information of Twin(s) need to be added here.)

Select	Twin	Name	Institution	Class	Birth Reg. No	DOB (MM/DD/YYYY)

Pre Academic Information

Class Name:	* (Example: PEC/JSC/SSC)
Name of School Attending at Present:	*	Enter Present School Name
Address of School Attending at Present:	*	Enter Present School Address

Present Address

Address :	*	Enter Address	Country :	*	Enter Country
District :	*	Enter District	Telephone :
Thana/Upazila :	*	Select Thana/Upazila	Mobile :
Postal Code :			City :	*

Permanent Address

Same As Present Address (If Permanent & Present Address are same please ☑ in box)

Address :	*	Enter Address	Country :	*
District :	*	Enter District	Telephone :
Thana/Upazila :	*	Select Thana/Upazila	Mobile :
Postal Code :			City :

Mobile Number to get Confirmation SMS

Address in Dhaka for correspondence :
Telephone No :
Mobile No :	* (For SMS & Further Communication)	Enter Mobile Number Enter Mobile Number
Emergency Contact No :	*	Enter Emergency Contact Enter Emergency Contact
Email :

Applicant's Coloured Photo

Applicant's Coloured Photo :

Verify Capcha :

qZnHkq

Enter Captcha

Please write the characters in the text box which is shown in the picture

আমি এতদ্বারা ঘোষণা করছি যে, আমার সর্বোত্তম জ্ঞান এবং বিশ্বাস অনুসারে আবেদনপত্রে উল্লেখিত সকল তথ্য সত্য, সম্পূর্ণ এবং সঠিক। আমি এও স্বীকার করছি যে, কোনো তথ্য অসত্য, মিথ্যা বা ভুল প্রমাণিত হলে কোনো কারণ দর্শানো ছাড়াই আবেদনপত্র অথবা ভর্তি বাতিল হলে আমার কোনো আপত্তি গ্রহণযোগ্য হবে না।
Terms and Conditions are required.

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