Application form for scholarship

Personal:Name Father’s NameMob No Home NoDate of Birth - - Father’s NIC - -Permanent AddressPresent Address

Financial:Name Guardian’s Profession Guardian’s Monthly Income

Others Sources of income

No of DependentFamily Members

No of Students in Family

Property/Land DetailEducation:

Name of institution Address & PhoneStudents Class Course of Study Year/Semester Monthly Fee Name of Teacher Contact Number Any distinction Hostel Expenses

Previous Results:Degree Total Marks Marks Obtained Percentage

Others:1. Are you already receiving any scholarship/interest free loan from some other sources like Fuji

Foundation or Bait-ul-Mal.? Yes / No if yes then how much annual.? ________________2. Is any of your brother or sister already getting scholarship from Alfalah Scholarship Scheme? Yes

No

Names Class

_____________________ _____________________________Student’s Signature Father’s / Guardian Signature

Certification from the head of the institution

I _______________________________________________________certify that the details above are correct to the best of my knowledge. The student is facing severe financial hardship to continue his/her student.

_____________________Signature Stamp & Date

Documents to be attached:1. Photocopy of self NIC.2. Photocopy of Guardian’s NIC (Father, Mother, Brother, Sister, Etc.)3. Photocopy each of Previous result like matriculation, Intermediate Etc.4. 3 Recent Photographs.5. Photocopy of Current Electricity Bill.6. Photocopy of Father/Mother/Brother/Sister’s Pension Book/Salary Slip.7. Bonafide certificate mentioning date of start/end date of course

This from should only be filed by a student who is 1. Facing financial obstacles to continue his/her student2. Good academic record (Minimum 60% Marks) and be a student of registered education

institution in Pakistan.

Office Use OnlyReceiving Date Ref. No Reg. NoAccepted for:

Interview Inquiry Approval CommitteeRejected due to:Less 60% Marks Out of Area Over Date Other

_________________________ __________________Admin Manager’s Signature PM/APM’s Signature

Approval Committee Decision:Approved

From - - To - - Monthly/Semester

ScholarshipAmount Hostel Expenses Total

Rejected Sufficient Resources Wrong Information Other

Approval Committee Members’ Signature

____________________ ____________________ ____________________ Name & Signature Name & Signature Name & Signature