Riz Scholars Application Form
Riz Scholars Application Form
Statement of Truth and Authentication (Application will be rejected if any signatures are missing )
I, the undersigned, swear that the information provided by the application in this form is correct.
Name of Applicant: ____________________________________ Signature of Applicant: ______________________ Date: ______________
Name of Guardian: ____________________________________ Signature of Guardian: ______________________ Date: ______________
Name of Faculty Member: ______________________________ Signature of Faculty Member: ________________ Date: ______________
Faculty Members Contacts: Phone No. __________________ Fax No: ___________________ Email: _______________________________
Personal Information
Applicants ID Number: _________________________
Fax: _________________________________________
Approved u/s 2(36) of the Income Tax Ordinance 2001 (2(36)CIT(c)/2005/J.Br/745, dated 2.8.2005)
Economic Information
Please name all the members of your family:
Name: _____________________ Relationship: _______________
Give details of your household income. Please include all salaries and all other income:
Salary 1 Rs. ____________ per mth. Earned by: ______________
Does your family own the house that you live in right now? Yes: ______________ No: _______________
Is your mother a single parent and earning a living for the family? Yes: ______________ No: _______________
Have you given tuitions or done any other work to earn some money? Yes: _____________ No: _______________
Did you go to a private school or a government school? __________________ What was the school fee? Rs. ___________ month
Academic Information
Period of Study
From
To
Institution
Class/Yr
Program
Grade Achieved
Approved u/s 2(36) of the Income Tax Ordinance 2001 (2(36)CIT(c)/2005/J.Br/745, dated 2.8.2005)
Scholarship Information
One time admission fee: Rs. _____________________
Evaluators Name
Comments
Recommended?
Date
Additional Comments:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Total points obtained: ___________________
Date: _____________________________________
Approved u/s 2(36) of the Income Tax Ordinance 2001 (2(36)CIT(c)/2005/J.Br/745, dated 2.8.2005)