Independent University, BangladeshFinancial Aid Office

Application for Financial Aid/ tuition fees discount

Please note:Please provide all information in full. Students' academic performance will be reviewed atthe end of each semester for continuation of the waiver. Incomplete form may result indenial.

Name of the student :

Student's ID :

Postal Address :

Telephone (Mobile and Land phone both) :

Date of birth :

E-mail :

Do you enjoy any other Tuition fees waiver/ Financial Aid offer by IUB? Yes. No.If Yes , please tick the following:

Based on pre University Result Merit Scholarship (100%) Top scorer at IUB Admission Test Special case Others (please specify)

From which semester and year: Discount Percentage (%):

Name of your sibling/spouse (if any student in IUB) :ID :

Academic Performance: SSC/O Level Year: Result: HSC/A Level Year: Result: Last completed semester at IUB Total earned credits: CGPA:

Signature of the applicant: Date:

Recentpassport sizephotograph(one copy)

Financial Guarantor Information

Financial Guarantor's Name:Address :Occupation:Telephone/cell number:Relationship with the applicant : Father Mother Spouse Employee Self Others (Please specify)

No. of dependents for whom tuition is paid :

Financial Information:

Annual income Amount (Taka) Salary (per month) Business Agriculture Investments Others(Please specify)

Assets/ Property Amount(Taka)

Signature of the Financial guarantor Date:

Please submit the following required papers for Financial aid/tuition feeswaiver:(a) TIN Certificate of financial guarantor.(b) Financial guarantors last three months bank statement.(c) Employee should submit Employers salary certificate from the employer.(d) Businessmen will submit a photocopy of the business trade license.(e) Birth certificates of both applicants (only for siblings).(f) Marriage certificate (only for spouse).(g) Freedom Fighters Child category:

Documents to be submitted:1. Certificate of a Freedom Fighter.2. Gazette copy.3. Certificate for the child from Ministry of Liberation War of Bangladesh Government.4. Birth certificate of the freedom fighters child.

Please provide two Reference names whom IUB can contact if needed : Name: Relation: Contact No.:

Name: Relation: Contact No.:

Signature of the Unit Head (Fin Aid Office) Date: