Application Cell Form

Note: Please fill this form accurately and in detail in MS Word. This form is for Roots IVY official use only

Name: Muhammad Hassan khan Campus: DHA-1 FLAGSHIP

Contact No: 03160565573 Email ID: [email protected]

Previous Counselor: Parents Email ID: [email protected]

Parents Cell No: 03340106176 Application Deadline: 15th june

03347977555
Program Chosen: Early Decision University:

Teacher Recommendations: Year of Joining Roots: 2020

(1 science/1 social science) e.g. Phy/ Eng

Select the right option:

a. Current Student b. Gap Year Student

List some keywords that define you (e.g. Creative, Intelligent, Friendly, Disciplined, Energetic, Entrepreneur, Humanitarian)

1. Energetic , Creative and disciplined

1) ACADEMIC RESULTS

Total (e.g
1A*4A2B1C/1A2B):_2A,3B,2C,1D_____________
_____ O’ Levels / Matriculation
Sr. # Subject Grades

1 pakstudies A

2 islamiyat B

3 urdu A
4 english C

5 maths C
6 chemistry D

7 biology B

8 physics B

10

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 AS / A2 Levels

(Mention actual results/subjects taken in AS or A2. If results are awaited mention the names of the subjects)
Sr. # Subject Grades Level (AS/A2)

1 CHEMISTRY

2 BIOLOGY

3 PHYSICS

2) List all academic awards received by you: (e.g. Gold Medal, IKMC, Spelling Bee)

Certificates in different competitions

3) Explain your family background in detail (parent’s profession, sibling’s education,

family circumstances and achievements)

There are 6 members in my family , starting from elder who is me after me I have my younger sister who is also

doing her alevel and after her there are two more younger little sisters doing there primary education. My

father is a government officer , to be precise he is serving in judiciary . My mother is a housewife , she had

masters in psychology . After our family got into a dark phase due to a major financial fraud my father struggled

and then he again uplift our family and then we migrated to the capital for better health and educational

facilities.

4) Why this program/subject of study? (Please explain why you are interested in this field.)

I’m interested in medical in order to serve humanity.

5) International Travel (if any)

a.

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6) ACADEMIC ACTIVITIES (e.g. Science Fairs, Business Expo, Kangaroo Maths, GIKI Olympiads, Robotics competitions, etc.
from grade 9 onwards)
Example:

Activity: Mathematics Club Position: President

Grade: 10 & 11 Year: 2018 / 2019

Timing of participation (Weeks/hours): 5 hours per week, 24 weeks a year

Details, awards, accomplishments and skills learned: I taught classes of junior students to help them gain a
better

understanding of the subject. I also organized the Roots Mathematics Olympiad and participated along with my team in the NUST Olympiad
where we won 2nd prize for our performance.

Activity 1: Position:

Grade: Year:

Timing of participation (Weeks/hours):

Details, awards, accomplishments and skills learned:

Activity 2: speech contest Position: runner up

Grade: 9th Year: 2020

Timing of participation (Weeks/hours): 1 hour in a week

Details, awards, accomplishments and skills learned: I’ve reacieved a certificate and it
helped me build a lot of self confidence and public speaking ability

Activity 3: Position:

Grade: Year:

Timing of participation (Weeks/hours):

Details, awards, accomplishments and skills learned:

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7) INTERNSHIPS (work experience etc.)
Internship 1: Position:

Grade: Year:

Timing of participation (Weeks/hours):

Details, awards, accomplishments and skills learned:

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 Internship 2: Position:

Grade: Year:

Timing of participation (Weeks/hours):

Details, awards, accomplishments and skills learned:

Internship 3: Position:

Grade: Year:

Timing of participation (Weeks/hours):

Details, awards, accomplishments and skills learned:

8) SOCIAL WORK (e.g. role in Earthquake relief operation, working with NGOs, SOS Village etc.)
Activity 1: Position:

Grade: Year:

Timing of participation (Weeks/hours):

Details, awards, accomplishments and skills learned:

Activity 2: Position:

Grade: Year:

Timing of participation (Weeks/hours):

Details, awards, accomplishments and skills learned:

Activity 3: Position:

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 Grade: Year:

Timing of participation (Weeks/hours):

Details, awards, accomplishments and skills learned:

9) ENVIRONMENT RELATED ACTIVITIES (e.g. An environment related project, ENO, WWF, Tree Plantation
Drive)
Activity 1: Position:

Grade: Year:

Timing of participation (Weeks/hours):

Details, awards, accomplishments and skills learned:

Activity 2: Position:

Grade: Year:

Timing of participation (Weeks/hours):

Details, awards, accomplishments and skills learned:

Activity 3: Position:

Grade: Year:

Timing of participation (Weeks/hours):

Details, awards, accomplishments and skills learned:

10) SPORTS (Football, Cricket, Badminton etc.)

Activity 1: tennis Position: 24th on national level

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 Grade: from 3 class till 10th Year: 2012-2020

Timing of participation (Weeks/hours): 417 weeks

Details, awards, accomplishments and skills learned : since my childhood I started to play tennis at safari club
nearby my house in bahria. After then I started to participate in national level tournaments and this achievement was beyond my imagination that I
received 24th ranking on national level and the love for tennis increased and still im playing it like a pro. Unfortunately due to covid many of my
tournaments were being cancelled but playing daily nearby my house in club is mandatory. It builded up my sportsman spirit, my health improved and my
stamna increased whereas I also learned time management and I wish one day I will become a pro tennis top player just like rogerer Federer my
inspiration.

Activity 2: GYM Position:

Grade: 7 till 11th Year: 2017 till 2020

Timing of participation (Weeks/hours): 928hours

Details, awards, accomplishments and skills learned: I have learned that huge
acheivements takes time which realized me the importance of patience and to never quit
whereas it improved my body shape and health ofcourse

Activity 3: Position:

Grade: Year:

Timing of participation (Weeks/hours):

Details, awards, accomplishments and skills learned:

11) ANY OTHER (Literary festivals, Arts symposiums, Drama performances etc.)
Activity 1: skit Position:

Grade: 5th till 7th Year: 2015 till 2018

Timing of participation (Weeks/hours): 12 hours

Details, awards, accomplishments and skills learned: it helped me to overcome my stage

fear.

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 Activity 2: Position:

Grade: Year:

Timing of participation (Weeks/hours):

Details, awards, accomplishments and skills learned:

Activity 3: Position:

Grade: Year:

Timing of participation (Weeks/hours):

Details, awards, accomplishments and skills learned:

12) COMMUNICATION SKILLS (Literary festivals, Arts symposiums, Drama performances etc. give examples)

a) Writing (Do you write poems, stories, blogs, books, reports etc)

b) Reading (Do you like to read? Fiction/Non-Fiction? What are you currently reading?)

history

c) Debating/Speeches (Participation in MUNs, debate competitions etc.)

d) Presentation Skills (Have you given any presentations? Discuss with examples.)

e) Performing Arts (Skits/Dramas/Tableau)

Skit , drama

f) Visual Arts (Drawing, painting, sketching, Photoshop)

painting

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13) What are your goals and ambitions?

To become a better person and to be useful for the world.

14) Who inspires you in life and why?

My father , because he is one of the most respectful Judge in Pakistan.

15) In what way your area of study will contribute to Pakistan and the world at large?

In health sectors .

16) Have you ever been a leader in your life in any event, academic activity, social group or

sports? Explain the event and your role.

17) Have you been a part of any activity meant for the global good? Explain. (Discuss any activity that

you were a part of which would be meant for the overall benefit of your own society and possibly for the world as well.)

I participated in planting trees which was organized by the government whereas I planted
many trees personally as well for the wellbeing of my country and globally as well

18) What are you most passionate about in life? What have you done more than others to

enhance this passion? (e.g. in Arts, IT, Acting, Music etc). Give examples.

music

19) Discuss your social qualities (e.g. humble, polite, sensitive to the needs of others, helpful, etc.)

I am very kind hearted , helpful and polite person

20) Discuss the strengths of your personality (e.g. energetic, self-confident, ability to organize workload, adventurous,

can handle stressful situations, interpersonal relationships, ability to handle setbacks etc.)

im very energetic, self-confident, have the ability to organize workload

21) What makes you unique and different from the others? Why should a top university in

the world consider you (e.g. you are a singer, musician, writer, debater, social worker, painter, actor etc)

social worker every Friday I gave charity to poors

22) Is there anything else you wish to inform your counselor about yourself?

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 I wish I get an opportunity to study abroad to widen my thinking and get a chance to study in a
change environment

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