APPLICATION FOR SCHOLARSHIP - 2018

Note:
1. Incomplete and/or late received applications will not be processed. 1 Recent Photo
2. Students studying in lavish institution will not be entertained.
3. Application form to be filled in with black pointer.
Required
4. Before filling the application form student must read instruction given on page # 3.

CATEGORY ( Tick the relevant)

Orphan
Disable
Need based

APPLICANT PERSONAL INFORMATION

1. Applicant’s name: _______________________________ 2. Father’s name: _______________________________
3. Applicant’s CNIC No: _____________________________ 4. Father’s CNIC No: _____________________________
5. Cell # (Student): _________________________________6. Cell # (Father): _______________________________
7. Date of birth: _____/____/_________ Email: _______________________________________________________
8. Present postal address: ___________________________________________________ District: ______________
9. Permanent postal address: ________________________________________________ District: ______________

EDUCATION INFORMATION
10. Class: ___________________ Course of study: ___________________ Year/Semester: _____________________
11. Institution: ___________________________________________________________________________________
12. Course start date: _____________ Course end date: ________________ Any distinction: ____________________
13. Monthly fee: _________________________ Hostel expenses: _________________________________________

PREVIOUS EDUCATION RECORD

Degree Year Percentage

Matriculation
Intermediate

FAMILY & FINANCIAL INFORMATION

15. Father’s/Guardian’s name: ____________________________________ Monthly income: ___________________
16. Father’s/Guardian’s professional status: ( Tick the relevant)
Govt. employee
Private employee
Self employed
Retired
Abroad
Un-Employed
Disabled
17. If father/mother/guardian/brothers/sisters are serving then give details: (Please attach extra page if more than one
family members are serving)
a. Name: __________________________________________ Cell #: ________________________________
b. Name of department /company/employer: __________________________________________________

1
 c. Address: ______________________________________________________________________________
d. Tel (Off): ________________________________ Cell #: (Employer)_______________________________
e. Designation & grade: ______________________ Total monthly salary: ___________________________
(Attach the relevant proof i.e. pay slip, copy of pension book etc.)
18. Total members in the family: (Applicant, his parents, brothers and sisters will be considered as family) ________
19. Details of siblings studying including the applicant’s own detail: (In case you have more details to enter please use
extra page)

Sr. Name Class/Course Educational Institute with Address Total Fee

Semester
Gender
# Per Month

1
2
3
4
5

20. Total fees & tuition charges of all siblings (Per month): __________________
21. Details of any other supporting person who is giving you a helping hand in your education.
Name: ___________________ Relation: _____________ Cell #: ________________ Amount being paid: _______
22. If you or any other sibling is getting financial support from any other government or non-government
organization give its details:

Name of beneficiary: ____________________ Organization: __________________ Amount being paid: ________

REFERENCES
23. Provide details of two persons as references to certify your given details. The said persons should be educated
and they should be well aware of your family circumstances:

1. Name: ________________________________ 2. Name: ________________________________

Profession/Occupation: ____________________ Profession/Occupation: ____________________
CNIC #: _________________________________ CNIC #: _________________________________
Cell #: __________________________________ Cell #: __________________________________

CERTIFICATION
24. Certification by the student and his/her father/guardian
It is certified that all particulars given above are correct.
Student’s signature: ________________ Father’s/Guardian’s signature: __________________ Date: __________

2
INSTRUCTION FOR STUDENTS
This page is only for the guidance of applicants and not to be sent with the application form.

Following attested documents must to be scanned and sent to imam-e-zamana-

scholarship@hotmail.com
1. Student’s CNIC.
2. Father’s/guardian’s CNIC.
3. 1 recent photograph.
4. Current electricity bill.
5. Father/mother/brother/sister’s pension book/salary slip/income certificate.
6. All previous exams’ result.
7. Fee slip (Last semester/year)
8. Hostel certificate (if applicable)
9. Bonafide certificate
10. References CNIC