Application Form for Faculty Positions at

Chittagong Independent University

(Please download this form, fill in and send it to the address mentioned in the advertisement)

SECTION: 1

I.Position applied for Lecturer (SoL) IX.A recent

Photograph
BADSHA MIA
II.Candidate’s Name
(Block Letters)
III.Father’s Name Abdul Sukkor

IV.Mother’s Name Fatema Begum

V.Date of Birth 6th March

VI.National ID No. 2212447303660

VII.Address
(Present)

VIII.Address X.Telephone
(Permanent) Vill. East Kharulia Khamar Para, P.O. Kharulia Number & E-mail
Bazar, P.S. Cox’s Bazar, Dist. Cox’s Bazar. Address

SECTION: 2

Education
(Please write the Subject in Honor’s & Master’s)
Examination School /College/University & Division/Class Year of
their locations /CGPA Graduation
1
SSC/O-Level
/Equivalent

HSC/A-Level/
Equivalent

Bachelor’s Degree
Major in

Master’s Degree
Major in

2nd Master’s (if any) in

PhD in

Others, if any

SECTION: 3

Publications
1. Book
Title Name of Publisher Place of Publication Year

2. Article
Title of the Article(s) Name of Journal Vol. – No. Year

2
 3. Conference Proceedings
Title of the Paper Conference Venue Details Year
Presented Organizer

4. Research Information
Title of Research Work Name of Supervisor, Designation & Office Year
Address / Sponsor

SECTION: 4

Referees (Please give names and contact details of 2 referees who shall be able to write
about your academic credentials, one of whom may be your colleague and another one
may be your direct teacher/supervisor):
Reference-1. Name & Address: Reference-2. Name & Address:

Telephone no. & e-mail ID: Telephone no. & e-mail ID:

SECTION: 5

Work Experience, if any (Most recent 3 jobs)

Institution & Address Designation Duration

3
Signature of Candidate: Date:

Note: Copies of the following items must be submitted along with this form otherwise the
application will not be considered:
i. Copy of NID
ii. Copies of all academic certificates / diploma and transcripts
iii. Copies of all listed publication(s)
iv. NOC/Release Letter/Clearance Certificate from immediate past employer, if
applicable