WEST COAST INSTITUTE OF MANAGEMENT & TECHNOLOGY

ONLINE ADMISSION FORM

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COURSE NAME

Civil Engineering Electrical Engineering Computer Engineering TeleCommunication Engineering

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PERSONAL INFORMATION

First Name

Last Name

Father Name

Mother Name

Date of Birth

Gender

Male Female

Address

Phone Number

Color Photo

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ACADEMIC BACKGROUND

Name of Exam SSC SSC (Voc) Dakhail HSC HSC (Voc)

Group / Subject Science Commerce Humanities Business Studies

Board / University Barisal Chattagram Dhaka Dinajpur Rajshahi Jessore Comilla Madrassa BTEB Open University

GPA A + A A - B + B B - C + C C -

School / College Name

Roll Number

Registration Number

Year of Passing

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BKASH PAYMENT KIOSK

bKash Reference Must be your SSC Roll Number

TRXID and Reference

bKash Sender Number

Paid Taka

Date of Payment

Submit