Application – Center for Professional Training and Research

Section B: Personal details

It is important that you provide these details as they are shown on your ID card / passport.

1. Surname/Family name:

2. Forename:

4. Father’s name:

5. Mother’s name:

6. Date of birth:

Place of birth:

7. Gender:MaleFemale

8. Nationality:

9. NID number (for Bangladeshi student)

Passport No (for international student)

Valid until:

Section C: Contact details

1. Permanent address:

2. Present/correspondence address (if different):

3. Mobile phone number:

4. Email address:

Section D: Upload documents

MBBS/MD/Equivalent:

Upload MBBS/MD/Equivalent Certificate

BMDC/Other Registration:

Upload BMDC/Other registration

CMD/DMU/Others:

Upload CMU/DMU Certificate

ID/Passport:

Upload Passport/NID

Recent photo:

Upload recent photo

Section E: Payment details

1st Installment (during application):

Upload payment slip/screen shot

Section F: Declaration

I confirm to the best of my knowledge that the information I have provided in this application is complete and correct. I am responsible for the information given in the application.

I understand that the information supplied on this form will be used for the purpose of processing my application and collecting feedback on the admission process. In addition, application data may be used for research purposes to better understand general recruitment and admissions administration including the analysis of applicant numbers and trends to improve the student experience and for strategic planning purposes. In the event that my application is successful, I understand that the information will form part of my student record. If admitted, I agree to abide by the regulations of the Commonwealth Open University, British Virgin Islands (UK) being in force now. I authorize the university to use photographs taken from social or other course activities, in which I might appear, for promotional purposes. I checked with my local registration/licensing authority for recognition of the degree offered by the Commonwealth Open University, British Virgin Islands (UK) and agreed to complete applied course in time.

Signed:

6. Date of birth:

Commonwealth Open University

Tortola, British Virgin Islands, UK

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