Shristy Institute :: For Health Sciences & Technology Ltd.

Shristy Institute for Health Sciences & Technology Ltd.

ADMISSION FORM

All Star (*) marks field are mandatory.
Please fill-up the application form in English. For better performance use Mozilla Firefox & Google Chrome latest version.

Who May Apply

+ Any medical graduate wishing to become a competent and confident sonologist
+ Have completed a certificate course in ultrasound and is seeking extensive training in both theoretical and hands-on scanning techniques
+ Are seeking to take an advanced hands-on scanning and didactic training after a period of work experience in ultrasound imaging
+ Wish to appear in American Registry of Diagnostic Medical Sonography (ARDMS) examination in USA or Canada

Course Registration

Year

Session

Student Type

Confirmation

If you are existing student, then select the checkbox.

Course Type

Course

Mandatory Subjects	Optional Subjects	Course Details
N/A Abdominal Ultrasound Abdominal Ultrasound Adult Echocardiography Fetal Anomaly & Genetic Scan Fetal Echocardiography Gynecology Ultrasound Gynecology Ultrasound Gynecology Ultrasound Gynecology Ultrasound Musculoskeletal Ultrasound (MSK) Neurosonology (Neonatal & Infant Brain) Neurosonology (Neonatal & Infant Brain) Obstetrics Ultrasound Obstetrics Ultrasound Obstetrics Ultrasound Obstetrics Ultrasound Scrotum & Penile Doppler Small Parts & Superficial Structure Ultrasound (Neck, Thyroid, Breasts & Scrotum) Small Parts & Superficial Structure Ultrasound (Neck, Thyroid, Breasts & Scrotum) Sonographic Principles & Instrumentation Sonographic Principles & Instrumentation Sonographic Principles & Instrumentation Sonographic Principles & Instrumentation Transvaginal Sonography Transvaginal Sonography Vascular Doppler Sonography (VT)	N/A	Duration : N/A Fee (৳) : N/A Fee ($) : N/A

Mandatory Subjects

Optional Subjects

Course Details

N/A

Duration : N/A

Fee (৳) : N/A

Fee ($) : N/A

BASIC INFORMATION

Fellow Name

BMDC Registration No

Father's Name

Mother's Name

Email Address

Mobile No

NID/Passport

Date of birth

Blood Group

Gender

Marital status

Religion

Nationality

Facebook ID

Skype ID

Viber Account No

WhatsApp ID

Contact person name

Contact person mobile no

Preferred time of Call

Proposed way of payment

Present place of work

Job description

Permanant Address

Division	District	Thana	Address

Mailing Address

Division	District	Thana	Address

Educational Qualification

Name Of Examination		Passing Year	Group/Batch	Board	Institute Name	Result(GPA/DIVISION)
S.S.C/ Equivalent
H.S.C/ Equivalent
Graduation
Post Graduation

WORK EXPERIENCE

Organization	Designation	Length of Service	Action
			Add More Remove

OTHER TRAINING PROGRAM ATTENDED

Training Name	Duration	Organization	Action
			Add More Remove

DOCUMENTS

Each document Size: 500Kb Max and only (jpg/png/pdf) is allowed to upload

MBBS Certificate

Select File Change Remove

POST Graduate Certificate

Select File Change Remove

NID/Passport

Select File Change Remove

Applicant's Image

Photographs of Fellow
(Image Size:300Kb Max, width & height(300 X 300 Pixel), only (.jpg) is allowed to upload)

Select Photo Change Remove

Applicant's Signature
(Signature Size:300Kb Max, width & height(300 X 80 Pixel), only (.jpg) is allowed to upload)

Select Signature Change Remove

I certify that the information on this application is true and complete in all respects and that I have withheld no information.

I understand that I have to provide documentation at some future date to substantiate my claims and that

Any misrepresentation of this information may result in cancellation of my admission or registration status.

I shall abide by all academic rules and regulations laid by Shristy Institute for Health Sciences & Technology Ltd.

And all future changes in said rules and regulations laid by Shristy Institute for further improvement in the course curriculum/delivery system.