Academic: Applicant Personal Information

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APPLICATION FOR SCHOLARSHIP - 2017

Note:
1. Incomplete and/or late received applications will not be processed.
2. Students studying in lavish institution will not be entertained.
3. Application form to be filled in with black pointer.
4. Before filling the application form student must read instruction given on page # 3.

CATEGORY ( Tick the relevant)


Orphan
Disable
Need based

APPLICANT PERSONAL
INFORMATION
1. Applicants name: _Zafar Ali 2. Fathers name: Muhammad Idrees__________
3. Applicants CNIC No: 4520878217847____________ 4. Fathers CNIC No: __
5. Cell # (Student): +923483514175 _6. Cell # (Father): _+923443182049
7. Date of birth: _28_/_01_/1998 Email: zafarbhellar16@gmail.com
8. Present postal address: _MUET Jamshoro Latif Hostel Room no. 06 __ District:
Jamshoro
9. Permanent postal address: Dilshad Electric Store Near LCS office High School
Road Ranipur District: Khairpur

10.Class:EDUCATION
__B.E(Chemical Engineering)_ Course of study: (Chemical Engineering)
INFORMATION
Year/Semester: _2nd year (Second year 1st Semester)
11.Institution: _Mehran University of Engineering and Technology Jamshoro
12.Course start date: 04-01-2016 Course end date: _31-12-2019__ Any distinction:
____________________
13.Monthly fee: _Academic 2215 rupees (26545 rupees yearly) Hostel

expenses:8000 /month
PREVIOUS EDUCATION
RECORD
Degree Year Percentage
Matriculation 2013 83.64%
Intermediate 2015 79.45%

15.Fathers/Guardians name: _Muhammad Idrees _ Monthly income: _17000/month_


16.Fathers/Guardians professional status: ( Tick the relevant)
FAMILY & FINANCIAL
Govt. employee
INFORMATION
Private employee
Self-employed (Farmer)
Retired
Abroad
Un-Employed
Disabled
17.If father/mother/guardian/brothers/sisters are serving then give details: (Please attach extra
page if more than one family members are serving)
a. Name: _____________None_____________________ Cell #:
________________________________
b. Name of department /company/employer:
__________________________________________________

1
c. Address:
______________________________________________________________________________
d. Tel (Off): ________________________________ Cell #:
(Employer)_______________________________
e. Designation & grade: ______________________ Total monthly salary:
___________________________
(Attach the relevant proof i.e. pay slip, copy of pension book etc.)
18. Total members in the family: (Applicant, his parents, brothers and sisters will be
considered as family) 07 members
19.Details of siblings studying including the applicants own detail: (In case you have more
details to enter please use extra page)

Sr. Name Class/Course Educational Institute with Total Fee

Semest
Gender
# Address Per

er
Month

1 Fozia F Matric - Government School Transpo


GAdegi rt
1000/m
onth
2 Shazia F Seventh Mazhar Muslim Model 1500/m
H/Sec School Ranipur onth
3
4
5

20.Total fees & tuition charges of all siblings (Per month): 2500/month__
21.Details of any other supporting person who is giving you a helping hand in your education.
Name: ___________________ Relation: _____________ Cell #: ________________ Amount being
paid: _______
22.If you or any other sibling is getting financial support from any other government or non-
government organization give its details:

Name of beneficiary: ____________________ Organization: __________________ Amount being


paid: ________

REFEREN
23.Provide
CES details of two persons as references to certify your given details. The said persons
should be educated and they should be well aware of your family circumstances:

1. Name: Mumtaz Ali _______ 2. Name: _HAdi


Profession/Occupation: _Lecturer Dino____________________

CNIC #: ____4520890457761______ Profession/Occupation: Farmer_______


CNIC #: _45208-4093922-
CERTIFICATI
Cell #: _+923013418154
24.Certification by the student and ___his/her father/guardian
It isON
7_______________
certified that all particulars given above are correct.
Students signature: ________________ Fathers/Guardians signature: __________________
Cell #:
Date: __________
__+923003580984___________

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INSTRUCTION FOR
STUDENTS
This page is only for the guidance of applicants and not to be sent with the application
form.

Following attested documents must to be scanned and sent to


imam-e-zamana-scholarship@hotmail.com
1. Students CNIC.()
2. Fathers/guardians CNIC. OK
3. 1 recent photograph. ok
4. Current electricity bill.
5. Father/mother/brother/sist ers pension book/salary slip/income certificate. OK
6. All previous exams result. OK
7. Fee slip (Last semester/year) OK
8. Hostel certificate (if applicable) OK
9. Bonafide certificate (App)
10.References CNIC (NAndhy bha)

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