Name of Applicant :
Nick name (known as in campus) :
Membership Category Applied for :
(Life Member) (General Member)
Please upload jpg or png 10mb size file :
Date of Birth :
NID No :
Blood Group :
Marriage Date :
Marital Status :
Please SelectMarriedUnmarriedDon’t like to mention
Please SelectIslamSanaton/HinduChristianBuddistDon’t like to mention
Any children with special need (is yes)?
Number of children :
Father's Name :
Mother's Name :
Permanent Address :
Present & contact Address :
Mobile No :
Email ID :
Contact Mobile Number :
Work type :
Please selectGovt jobNon-GovtBusinessSelf-EmployedPoliticsRetired
Your Current Position :
Name & Address of office :
Please selectBanglaEnglishHistoryPhilosophyArchaeologyDrama and DramaticsInternational RelationsJournalism and Media StudiesFine ArtsBotanyZoologyPharmacyBiochemistry and Molecular BiologyMicrobiologyGenetic Engineering and BiotechnologyScienceMathematicsPhysicsComputer Science and Engineering.Environmental scienceChemistryStatisticsGeological ScienceEconomicsAnthropologyGovernment and PoliticsGeography and EnvironmentUrban and Regional PlanningPublic AdministrationFinance & BankingMarketingAccounting and Information SystemsManagement StudiesLaw & Justice
Graduation Year :
JU Batch :
Residential Hall :
Please selectMir Mosharraf Hossain HallShaheed Rafiq-Jabbar HallShaheed Salam-Barkat HallNawab Faizunnesa HallMoulana Bhasani HallBegum Khaleda Zia HallA.F.M. Kamaluddin HallJahanara Imam HallFazilatunnesa Hall
Any Involvement in Cultural/Sports/other Activities ?
Which type :
Please selectSportsDramaMusicournalismDebate ClubOther
Are you registered Graduate ?
If Yes, Reg. Number :
Are you a member of any other Club/Association in Bangladesh ?
If Yes, Please mention the name and address below :
Do you have any special cultural skills ?
If Yes, Please mention below(e.g Vocal/Singer,Drama,Instrument-Flute,Giter,Tabla etc) :
Graduation Certificate scanned copy :
I do here by declare that the information above provided by me are fully true.If found false,the club authority reserves the right to take appropriate action (including cancellation of my membership) at anytime. I will fully abide by all the rules,regulations/policies,code of conduct of the Club. I was never involved with any type of anti-state activity and will never be.If found, my membership can be cancelled/terminated any time
1. The ENTRY FEE is Tk 200.00(two hundred) only for all types of membership.
2. Fees for Live Membership is Tk 5000.00(Taka five thousand) until changed by the authority.
3. Fees for General Membership(1 year) is Tk 500.00(five hundred) until changed by the authority.
4. Monthly Fees for life member is Tk 500.00(five hundred) until changed changed by the authority.
5. Monthly Fees for General member is Tk 300.00(three hundred) until changed changed by the authority.
6. Life Membership Fees For JU Teachers(JU Graduates) is Tk 5200(including Entry Fees).No monthly fee
is applicable for JU Teachers.
7. Along with this Application Form,please attach copy of your Graduation (Hons.)Certificate,a Copy of your National ID Card and 02 copies of recent PP size Photograph.