Online Application

Grameen Caledonian College of Nursing

Sector No-15, Road No-03, Uttara Model Town, Uttara Diabari, Dhaka-1230

Contact Cell: +88-01749194796

Web: www.gccn.ac.bd

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Course Where Applying For :

Session

Name of Applicant (Block Letter) :

Father's Name :

Profession :

Yearly Income :

Mother's Name :

Profession :

Yearly Income :

Total Familly Income :

Present Address :

Permanent Address :

Date of Birth :

Nationality :

Religion :

Marital Status :

Contact No :

Applicant:

Parents:

Email:

Local Guardian's 1 Information

Guardian's 1 Name:

Relation with Guardian

Guardian's Address:

Guardian's Phone

Local Guardian's 2 Information

Guardian's 2 Name:

Relation with Guardian

Guardian's Address:

Guardian's Phone

Academic Result:

Name of Examination	Passing Year(4 digits)	Registration No	Education Board	GPA with 4th subject	GPA without 4th subject
SSC or Equivalent
HSC or Equivalent
BSC in Nursing

Govt. Admission Test Date		Roll No.		Admission Score		Total Score

Bank Information:

Zone :

Area :

Branch :

Borrower No:

Group No:

Center No:

Cell No, Zone:

Cell No, Area:

Cell No, Branch:

From when are you a member of Grameen Bank:

Upload SSC Marksheet

Upload HSC/Diploma Marksheet

Govt, Admission Test Marksheet

Upload BSC Marksheet

I declare that the above information is true. If any false information is found; my application will be cancelled. I further declare that I shall fully abide by the rules and regulations of the institution and any decision of the institution to which I may be admitted. In case of violation, I will be obliged to follow any decision taken by the college authority. After registration, if I cancel my admission, I will pay 50% of course fee.

Signature of the Parent/ Local Guardian

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Signature of the Applicant

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