CISCO LOCAL ACADEMY
Baghdad-ul-Jadeed Campus
THE ISLAMIA UNIVERSITY OF BAHAWALPUR
Phone # 062-9255466
http://www.iub.edu.pk Paste your
recent
APPLICATION FORM FOR ADMISSION IN PICTURE
“CCNA Training Program”
1. Name : _______________________________________________________________
2. Gender : Male / Female
3. Date of Birth : __________________________________________________________
4. Postal Address : _____________________________________________________
_____________________________________________________
(Contact No.) Phone: ___________________________________
E-mail: ___________________________________
5. Marital Status : Married / Single
6. Father's / Guardian's /Husband
(a) Name : ________________________________________________
(b) Occupation : ________________________________________________
(c) Address : ________________________________________________
________________________________________________
7. Qualifications: (Attach Certificates of recent three Qualifications only)
Board/University/Institute Examination Year of Subject %age of
Passing Marks
8. Applicant's Occupation: (if employed)
(a) Occupation : ________________________________________________
(b) Company Name: _______________________________________________
(c) Nature of Job: _________________________________________________
(d) Company Address:_____________________________________________
(e) Tel No : _________________________________________________
9. Knowledge of Computer Applications: Yes / No
(If yes attach certificate)
10. Any additional information which you perceive as relevant:
__________________________________________________________________________
_________________________________________________________________________
Date:______________ Signature of the Candidate
________________________________________________________________________________
FOR OFFICE USE ONLY
1. Receiving Date : ________________________________
2. Serial No. Allotted : ________________________________
3. Registration No. : _________________________________
4. Batch Code : _________________________________
The completed form with all enclosures must reach the address below by
CISCO LOCAL ACADEMY
DEPARTMENT OF COMPUTER SCIENCE & IT
BAGHDAD-UL-JADEED CAMPUS
THE ISLAMIA UNIVERSITY OF BAHAWALPUR