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SrNo:___________
FinancialAssistanceForm
Checktherightschemeforfinancialassistance Scholarship Interestfreeloan
APPLICANT'SNAME
30KmTalagangRoad,Mianwali,www.namal.edu.pk,admissions@namal.edu.pk,Tel:+92459816816
SECTIONA:FAMILYDETAILS
FATHER'SNAME: GUARDIAN'sNAME: C.N.I.C# ORGANIZATION: GRADE: PROFESSION: OFFICIALADDRESS: STATUS: Alive
Deceased
Father'sAge:
Years
Ifyourfatherisnotalivethengivethefollowinginformationaboutyourguardian.
DESIGNATION
TELEPHONE:
OFF
CELL
RES MembersDependentonyourFather/Guardian:
GROSSMONTHLYINCOME: NUMBEROFFAMILYMEMBERS:
MEMBERSLIVINGWITHYOU:
Pleasefillthedetailsofearningmembersbelow:
NO: 1 2 3 4 5 NAME RELATION PROFESSION ORGANIZATION DESIGNATION
*PleaseattachthebankstatementsoflastSixmonths
Givedetailsofthebrothers/sisters/othersstudying
NO: 1 2 3 4 5 NAME RELATION INSTITUTE FEEPERMONTH CLASS/ STAGE
SECTIONB:ACCOMODATIONDETAILS
Bungalow Flat House Selfowned Familyowned Govtowned Electricity Rented Gas Phone Water
TYPEOFACCOMODATION:
Self Family Govt Others
RENTPAIDBY: HOUSEPLOTSIZE
SECTIONC:DETAILSOFASSETS
Yes No Residential Commercial Agriculture Others
TYPEOFTHEPLOT/LANDOWNED:
INCOMEOFTHELAND/PLOTOWNED:
Yes
perAnnum
No
WORTHOFTHEPROPERTYOWNED:
Car Bus Others
SECTIOND:References:Notabloodrelativebutknowntoyouforatleastthreeyears
1) TELEPHONE: 2) TELEPHONE: OFF CELL RES OFF CELL RES
SECTIONE:ACADEMICRECORDDETAILS:Fillinformationgivenbelowonly,noextrainformationisrequired.Incompleteinformationwillresultindisqualificationforadmission.
Certificate /Degree SSC/ O SSC/'O' Level HSSC/'A' Level/DAE Other(s) Degree Title Yearof Passing %Marks English %Marks Mathematics %MarksPhysics %Marks Comp.Sc. Total% Marks/CGPA Board/University
SECTIONF:DECLARATION
Iherebysolemnlyundertake/declarethatIhavepersonallyfilledinthisapplicationformandtheinformationcontainedthereiniscompleteandaccurate tothebestofmyknowledgeandbelief.IunderstandthatwithholdingorgivingfalseinformationwillmakemeineligibleforscholarshipatanystageandI willpaybackalltheamount.IfurtherunderstandthatImayberequiredtoappearforaninterviewrequestedbytheCollegeAdmissionCommitteeasa conditionforthefinancialassistancetotheprogrammeofstudyforwhichIhaveapplied.
Parent/Guardian'sSignature Date:
Applicant'sSignature Date:
GazettedOfficer'sSignature Date:
Pleaseensurethatyouhaveattachedallthefollowingdocuments:
OriginalBankdepositslipofRs:1000/forfinancialassistanceform. Copyofbillsofgas,electricityandtelephone. Proofofincome&incometaxpaidduringlasttwoyears. Bankstatementoflastsixmonths.
Comments:
FeePerYear Scholorshipperyear Loanperyear Payableperyear
AdmissionOfficer'sSignature
AdmissionTutor'sSignature
DeputyViceChancellor'sSignature 2