To be filled by the Office
The applicant should fill all columns in capital letters.
Tick ( ) mark the appropriate box where necessary.
Program Applied For (Please indicate first, second and third choice by writing 1, 2 and 3 in the boxes.
At least one box must be filled. Cross out blank boxes.)
UNDERGRADUATE EVENING CERTIFICATE GRADUATE PROGRAMS
PROGRAMS PROGRAM MBA MS (Economics)
BBA CERTIFICATE MBA – MIS MS (Finance)
BBA – MIS PGD / MBA (Evening) Ph.D. (MIS/CSE / ICT)
BCS MBA – MIS (Evening)
Date of Birth (dd/mm/yy) Sex: Male Female Marital Status: Single Married
(If applicant does not have an NIC, give Father’s/Guardian’s NIC#)
Place of Birth Nationality Domicile
Father’s Name Alive Deceased
Father’s Profession Annual Income
Organization Where Employed
Guardian’s Name Relationship with Guardian
Guardian’s Profession Annual Income
Organization where Employed
Tel. (Res.) Mobile Office Email
QUALIFICATIONS SCHOOL/COLLEGE BOARD / YEAR OF PASSING GRADE MAJOR SUBJECTS
/UNIVERSITY UNIVERSITY Annual/Supp. Seat No. /GPA
Matriculation or Equivalent / ‘O’-Level
*Intermediate or Equivalent /
Other relevant – specify
‘A’-Level students if waiting for the results should mention their subjects here 1.
2. 3. 4.
* Minimum 50% marks in intermediate / 3 C’s (excluding General Paper) are required in A-Level
** Strike off items not applicable. For Bachelors or Masters examination, a minimum of score 50% is required.
If applicant is awaiting the results, please attach the admit card/statement of entry with this form.
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Have you appeared in the IBA Aptitude test for admission previously? YES NO
If Yes, when? What was the score? Selected Yes No
Have you taken any test administrated by Educational Testing Service (ETS), USA during last three years? YES NO
TOEFL Date (dd-mm-yy) Score
SAT Date (dd-mm-yy) Score
GMAT Date (dd-mm-yy) Score
GRE Date (dd-mm-yy) Score
Name Of The Company Title/Position From (month/year) To (month/year)
REFERENCES (One reference may be your teacher/instructor)
If you are Ph.D. candidate, please attach two reference letters from the institute you last attended.
I hereby certify that the information given above is correct and I take full responsibility for any incorrect information. I
clearly understand that acceptance of my application form and appearance in the test does not mean approval of my
I hereby agree to abide by the rules and regulations of the IBA, as applicable currently, and revised/updated/enforced,
during the currency of program.
Date (dd-mm-yy): ______________________ Applicant’s Signature ____________________________
FOR OFFICIAL USE ONLY
Vocabulary Quantitative Intelligence General knowledge Total