S No:_________

For 0ffic Us 0nl!: Date of Re#ei(t: _______ 1ntran#e Test Roll No: ___ 1ligi5le ! Not 1ligi5le Remar s: ________

PAKISTAN NAVY

.aste 9tteste$ .hotogra(hs From Front &.: x &.: #m

Application Form for Admission MBBS at Bahria Univ rsit! M dical " # ntal $oll % &A%ainst s ats r s rv d for $hildr n of S rvin%'( tir d PN P rsonn l Incl)din% S rvin% PN $ivilian*

Not :

(1) Please read the instructions given overleaf at para 8 carefully before filling this Form. (2) Candidates are required to apply to ahria !niversity "edical # $ental College on the prescribed !niversity%College &dmission Form and to appear in the entrance test. (') Candidates are required to send attested photocopy of the !niversity%College &dmit Card to ()* $te (+,.slamabad.

1. STU#+NT,S PA(TI$U-A(S: Name:___________________________________________________ Sex :________________________________ Date of Birth: ___________________ NIC No or Registration No of Form B: _____________________________ Tele No.: _____________________________________ Cell No.: ________________________________________ 2. FAT.+(,S PA(TI$U-A(S: Name : __________________________ Ran !Rate:____________________ Ser"i#e No.:____________________ Ser"ing!Retire$: _______________ %nit Borne : _______________________Total Ser"i#e___________________ &. A##(+SS: 'If (ermanent an$ #)rrent a$$resses are same* +rite onl, (ermanent a$$ress.resent ______________________________________________________________________________________ _____________________________________________________________________________________________ Tele No.'Res- : _______________________ Tele '/ff-:__________________ Cell No.:______________________ .ermanent ____________________________________________________________________________________ ________________________________________ Tele No: ____________________________________________ 0. A$A#+MI$ /UA-IFI$ATI0NS: +1amination SSC!12)i"alent 3SSC!12)i"alent 4. UN#+(TAKIN4 F(0M APP-I$ANT: Y ar of Passin% Total Mar2s Mar2s 03tain d P rc nta% Board Att nd d

I here5, #ertif, that entries ma$e 5, me in this a((li#ation form are #om(lete an$ #orre#t to the 5est of m, no+le$ge an$ that I agree to a5i$e 5, the r)les an$ reg)lations of Bahria %ni"ersit, 6e$i#al 7 Dental College an$ .a istan Na", 5oth. I )n$erstan$ an$ a##e(t that fail)re to #om(l, +ith these r)les 7 reg)lations #an res)lt in m, ex()lsion from the #ollege. Date8888888 Signat)re of 9((li#ant88888888888... .T/

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UN#+(TAKIN4 F(0M FAT.+('4UA(#IAN a. I here5, #ertif, that m, son!$a)ghter ma es this a((li#ation +ith m, no+le$ge an$ #onsent an$ that I +ill 5e res(onsi5le for his!her #on$)#t an$ other lia5ilities )n$er the r)les $)ring the st)$ies at the Bahria %ni"ersit, 6e$i#al 7 Dental College. 5. S)ita5le arrangement for his!her a##ommo$ation +ill 5e ma$e in #ase of his!her sele#tion an$ non< a"aila5ilit, of a##ommo$ation at the #on#erne$ #ollege. #. I )n$erta e to 5ear all (res#ri5e$ ex(enses of the #o)rse. Signat)re of Father!=)ar$ian8888888888.

Date88888888 >. INST(U$TI0NS: a. 5. #. $. e. ?.

.lease fill in all entries in 5lo# letters in legi5le han$+riting.. 9"oi$ o"er+riting. 9tteste$ (hoto#o(ies of all testimonials!#ertifi#ates an$ other $o#)ments m)st a##om(an, the 9((li#ation Form as (er se2)en#e "i$e (ara 11 5elo+. Incompl t Application Form 5ill not 3 acc pt d6 Provision of th ntranc t st r s)lt is th r sponsi3ilit! of th candidat 66

+-I4IBI-ITY a. 5. #. $. e. f. g Chil$ren of the ser"ing!retire$ .N /ffi#ers!C./s!Sailors in#l)$ing Ser"ing .N Ci"ilian +ith a minim)m of 1: ,ears of ser"i#e from $ate of @oining +ill 5e #onsi$ere$ for a$mission against reser"e$ 2)ota seats. 9rm,!.9F (ersonnel on se#on$ment!$e()tation to .N are not eligi5le. 9 #an$i$ate m)st f)lfil (rere2)isites an$ other eligi5ilit, #on$itions of the College!%ni"ersit,. 9 #an$i$ate m)st ha"e o5taine$ a minim)m of 4AB mar s in aggregate ea#h in matri# 'SSC- an$ 3SSC '.re<6e$i#al +ith Biolog,* Chemistr,* .h,si#s 7 1nglish- or e2)i"alent ex#l)$ing NCC mar s. British 9$"an#e$ Ce"el Certifi#ate +ith Biolog,* Chemistr, an$ .h,si#s. The a#hie"ements sho)l$ 5e at least 4AB '.re<6e$i#al- in IBCC 12)i"alen#e Certifi#ate. 0( %S =ra$e<12 or Cana$ian<=ra$e 12 or 1& Di(loma '6inim)m C=.9 &.A- a##om(anie$ 5, an 12)i"alen#e Certifi#ate from the IBCC of at least 4AB F.S# .re<6e$i#al 2)alifi#ation 'that +ill re2)ire in#l)sion of Biolog,* Chemistr,* .h,si#s* an$ 1nglish in the final & ,ears- 0( 3igher Se#on$ar, S#hool Certifi#ate from other #o)ntries +ith Biolog,* Chemistr, an$ .h,si#s a##om(anie$ 5, an 12)i"alen#e Certifi#ate from IBCC of at least 4AB F.S# .re<6e$i#al 2)alifi#ation. ntr! t st is ss ntial for all applicants r sidin% in Pa2istan6

+ntr! T st: $oll % 1A.

Alt rnat to +ntr! T st: 9s alternate o(tion to the entr, test* the #ollege +ill a##e(t one of the follo+ing 2)alifi#ations: a. 5. #. Not : S9T<II in Biolog,* Chemistr, an$ .h,si#s 'minim)m s#ore of 4:A ea#h in at least t+o s)5@e#ts-. 6C9T in Biolog,* .h,si#s an$ Chemistr, '6inim)m s#ore re2)irement is 20-. 9. '9$"an#e .la#ement- in Biolog,* Chemistr, an$ .h,si#s* '6inim)m s#ore re2)irement of 0 in ea#h s)5@e#tS9T<II an$ 9. s#ore sho)l$ not 5e more than three #alen$er ,ears ol$.

11.

#0$UM+NTS T0 B+ ATTA$.+# 7IT. APP-I$ATI0N F0(M: a. 5. #. $. e. 9tteste$ (hoto#o(, of SSC!12)i"alent Certifi#ate an$ 6ar s sheet. 9tteste$ (hoto#o(, of 3SSC!12)i"alen#e #ertifi#ate an$ 6ar s sheet. 9tteste$ (hoto#o(, of Can$i$ates NIC or Form DB 'if NIC not iss)e$-. Fathers Ser"i#e Certifi#ate 'in #ase of Ser"ing .ersonnel a #ertifi#ate from Comman$ing /ffi#er!Comman$ant of the %nit mentioning Ran !Rate* Name an$ total $)ration of the ser"i#e-. 9tteste$ (hoto#o(, of Fathers!=)ar$ians Retirement Boo 'In #ase of Retire$ Ser"i#e .ersonnel-.

g.

Chara#ter #ertifi#ate from the last instit)tion atten$e$.