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APPLICATION FOR SCHOLARSHIP
(Submission Date 1st
Aug – 31st
Oct)
REGION:_____________________
Note:
1. Incomplete/late received applications will not be entertained.
2. Applicants having 70% marks (Matric) and 60% marks (Inter, DAE and above) in their
last Board Exam will only be eligible to apply. However Minority students having 60%
marks (Matric) and 55% (Inter,DAE and above) can apply.
3. Students studying in lavish institution will not be entertained.
4. Application Form to be filled in with black pointer.
5. Old Application Form will not be accepted.
6. Before filling the Application form student must read instruction given on page # 3.
7. (For office use) Diary # ______________________ Reg. #_____________________
CATEGORY ( Tick the relevant) Orphan Disable Needbased Muslim Non-Muslim
1. Applicant’sName: ______________________________ 2. Father’sName:_______________________________
3. Applicant’sCNICNo_____________________________ 4. Father’sCNICNo _____________________________
5. Cell # (student):1)___________________2) ___________________ 6. Cell # (Father):______________________
7. Date of birth:_____/____/_________Email: __________________________________ Tel (Res.) ______________
8. PresentPostal Address:___________________________________________________ District:_______________
9. Permanent Postal Address:________________________________________________ District:_______________
10. Class___________________ Course of Study___________________ Year/Semester______________________
11. Institution__________________________________________________ ContactNo.________________________
12. Course start date:_____________Course enddate: ________________ Anydistinction_____________________
13. MonthlyFee:_________________________ Hostel Expenses:_________________________________________
14. Name of Teacher __________________________________________ ContactNo.__________________________
15.
Degree Year Total Marks Marks Obtained Percentage
Matriculation
Intermediate
15. Father’s/Guardian’sName:_____________________________________ MonthlyIncome:___________________
16. Father’s/Guardian’sprofessional status: Govt.Employee Private Employee
Self-Business Retired Abroad Un-Employed Disabled
APPLICANT PERSONAL INFORMATION
3 Photos
Required
Size (2” x 1.5”)
(Not Attested)
PREVIOUS EDUCATION RECORD
FAMILY & FINANCIAL INFORMATION
EDUCATION INFORMATION
Session
2016-17
2
17. If Father/Mother/Guardian/Brothers/Sistersare servingthengivedetails (Plzattach extra page if more than one
family members areserving)
a. Name __________________________________________Cell #: ________________________________
b. Name of Department/Company/Employer:_________________________________________________
c. Address:_____________________________________________________________________________
d. Tel (Off):________________________________ Cell #: (Employer)__________ ____________________
e. Designation&Grade ______________________ Total MonthlySalary____________________________
(Attachthe relevantProof i.e payslip,copyof pensionbooketc.)
18. If Father /Brothersare shopkeepersgive detail of Shop(Nature of Shop/Volume of Shop) ___________________
Total monthlyincome Rs:_______________________________________________________________________
19. Total Membersinthe Family: (Applicant,hisparents,brothersandsisterswillbe consideredasfamily)
20. Detailsof SiblingsStudyingincludingthe applicant’sowndetail
Sr.
#
Name
Gender
Class/Course
Semest
er
Educational Institute with
Address
Type of
Institute
(Govt./Private)
Total Fee
Per
Month
1
2
3
4
5
(Incase youhave more detailstoenterplease use extrapage)
21. Total Fees&TuitionChargesof all siblings(PerMonth) Rs/-__________________
22. Detailsof anyothersupportingpersonwhoisgivingyoua helpinghandinyoureducation.
Name:___________________ Relation_____________ Cell # ________________ Amountbeingpaid_________
23. If you or any othersiblingisgettingfinancial supportfromAlfalahoranyotherGovernmentorNon-government
organizationgive itsdetails
Name of Beneficiary:____________________ Organization __________________ Amount of Stipend _________
24. Provide detailsof two personsasreferencestocertifyyour givendetails.The saidpersonsshouldbe educated
and theyshouldbe well aware of yourfamilycircumstances
25. Certificationby the student and his/herfather/guardian
It iscertifiedthatall particularsgiven above are correct.
Student’sSignature ________________ Father’s/Guardian’sSignature __________________Date: ___________
26. Certificationby the Head of Institution
It iscertifiedthat above namedapplicantisbonafide studentof thisinstitutionandrecommendedforgrantof
scholarshipbeingadeservingone.
Name ______________________________________
Designation_________________________________
Signature ___________________________________
Date: _______________________________________
Office Stamp (Must be Readable)
REFERENCES
1. Name:----------------------------------------------------
Profession/Occupation:---------------------------------
CNIC# ------------------------------------------------------
Cell # --------------------------------------------------------
2. Name:----------------------------------------------------
Profession/Occupation:---------------------------------
CNIC# ------------------------------------------------------
Cell # --------------------------------------------------------
CERTIFICATION
3
‫صفحہ‬ ‫(یہ‬‫صرف‬‫درخواست‬ ‫اسکو‬ ‫ہے‬ ‫لیے‬ ‫کے‬ ‫راہنمائی‬ ‫کی‬ ‫طلبہ‬‫فارم‬‫ساتھ‬ ‫کے‬‫لف‬)‫کریں‬ ‫نہ‬
This page is only for the guidance of applicants and not to be attached with application form.
Attesteddocuments tobe attached
1. Photocopyof Self’sCNIC.
2. Photocopyof Father’s/Guardian’sCNIC.
3. 3 RecentPhotographs.
4. Photocopyof currentElectricityBill.
5. Photocopyof Father/Mother/Brother/Sister’sPensionBook/SalarySlip.
6. Photocopyof all previousexams’result.
7. Photocopyof fee slip(Lastsemester/year)
8. Hostel certificate (if applicable)
9. Bonafide Certificate (Mentioningcourse startandendingdates)
Only those applicants may apply who are:-
1. Facingacute financial hardshiptocontinue theirstudies.
2. Having good academic record in last Board/University exam with minimum 70% marks (Matric) and 60%
marks (Inter, DAE and above). Minorities 60% marks (Matric) and 55% marks (Inter, DAE and above).
3. Bonafide students of Govt. institutes. However students of intermediate class studying in a registered
private institutions may apply.
Note: Call on cell phone during office hours(9:00am – 5:00pm) avoid to call duringNAMAZ time please.
Application form to be submitted to concerned region. Addresses are given below:-
PUNJAB SINDH BALOCHISTAN
Haris Nazir
(Program Manager, Education)
AlkhidmatFoundation Punjab
Mansorah,Lahore
Cell:0300-2440764
Ph: (Office) 042-35413038
Muhammad Hussain
AlkhidmatFoundation Sindh
Street # 3, Kaba Auditorium, Block 13
Federal B Area, Karachi
Ph: (Office) 021-36344621
021-36345131
Muhammad Sadiq Mengal
AlkhidmatFoundation Balochistan
165 Samungli HousingScheme
Samangli Road Quetta
Cell:0333-7929916
Ph: (Office) 081-2826115
KPK FATA KARACHI
Muhammad Adil
AlkhidmatFoundation Khyber
Pakhtunkhwa
B-39, Street # 6, Sikandar Town,
G. T. Road Peshawar
Cell:0316-1208337
Ph: (Office) 091-22613771
Hameed Afridi
AlkhidmatFoundation FATA
Safi Town Gulbahar No. 5 (Adjacent to
Jamia Alhadia)
Near Ring Road – Peshawar
Cell:0333-9052327
Ph: (Office) 091-2262327
QasimRasheed
AlkhidmatWelfare Society Karachi
504, Qaideen Colony, Near Islamia
College, Karachi
Cell:0333-2231446
Ph: (Office) 021-34915361-4
AJK GILGIT/ BALTISTAN
Engr. Muhammad Khalid
AlkhidmatFoundation AJK
B-1, 2nd floor, Flat# 2, Noor Plaza,
Chandani Chowk, Setlite Town
Rawalpindi
Atif Abbasi (ProgramManager)
Cell:0346-5194373
Ph: (Office) 051-4421190
Tahir Rana
AlkhidmatFoundation Gilgit& Baltistan
Near China Trade Center
Gilgit
Cell:0346-9212525
Ph: (Office) 05811-457039
INSTRUCTIONFOR STUDENTS

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Revised application-form-for-ss-2016-17

  • 1. 1 APPLICATION FOR SCHOLARSHIP (Submission Date 1st Aug – 31st Oct) REGION:_____________________ Note: 1. Incomplete/late received applications will not be entertained. 2. Applicants having 70% marks (Matric) and 60% marks (Inter, DAE and above) in their last Board Exam will only be eligible to apply. However Minority students having 60% marks (Matric) and 55% (Inter,DAE and above) can apply. 3. Students studying in lavish institution will not be entertained. 4. Application Form to be filled in with black pointer. 5. Old Application Form will not be accepted. 6. Before filling the Application form student must read instruction given on page # 3. 7. (For office use) Diary # ______________________ Reg. #_____________________ CATEGORY ( Tick the relevant) Orphan Disable Needbased Muslim Non-Muslim 1. Applicant’sName: ______________________________ 2. Father’sName:_______________________________ 3. Applicant’sCNICNo_____________________________ 4. Father’sCNICNo _____________________________ 5. Cell # (student):1)___________________2) ___________________ 6. Cell # (Father):______________________ 7. Date of birth:_____/____/_________Email: __________________________________ Tel (Res.) ______________ 8. PresentPostal Address:___________________________________________________ District:_______________ 9. Permanent Postal Address:________________________________________________ District:_______________ 10. Class___________________ Course of Study___________________ Year/Semester______________________ 11. Institution__________________________________________________ ContactNo.________________________ 12. Course start date:_____________Course enddate: ________________ Anydistinction_____________________ 13. MonthlyFee:_________________________ Hostel Expenses:_________________________________________ 14. Name of Teacher __________________________________________ ContactNo.__________________________ 15. Degree Year Total Marks Marks Obtained Percentage Matriculation Intermediate 15. Father’s/Guardian’sName:_____________________________________ MonthlyIncome:___________________ 16. Father’s/Guardian’sprofessional status: Govt.Employee Private Employee Self-Business Retired Abroad Un-Employed Disabled APPLICANT PERSONAL INFORMATION 3 Photos Required Size (2” x 1.5”) (Not Attested) PREVIOUS EDUCATION RECORD FAMILY & FINANCIAL INFORMATION EDUCATION INFORMATION Session 2016-17
  • 2. 2 17. If Father/Mother/Guardian/Brothers/Sistersare servingthengivedetails (Plzattach extra page if more than one family members areserving) a. Name __________________________________________Cell #: ________________________________ b. Name of Department/Company/Employer:_________________________________________________ c. Address:_____________________________________________________________________________ d. Tel (Off):________________________________ Cell #: (Employer)__________ ____________________ e. Designation&Grade ______________________ Total MonthlySalary____________________________ (Attachthe relevantProof i.e payslip,copyof pensionbooketc.) 18. If Father /Brothersare shopkeepersgive detail of Shop(Nature of Shop/Volume of Shop) ___________________ Total monthlyincome Rs:_______________________________________________________________________ 19. Total Membersinthe Family: (Applicant,hisparents,brothersandsisterswillbe consideredasfamily) 20. Detailsof SiblingsStudyingincludingthe applicant’sowndetail Sr. # Name Gender Class/Course Semest er Educational Institute with Address Type of Institute (Govt./Private) Total Fee Per Month 1 2 3 4 5 (Incase youhave more detailstoenterplease use extrapage) 21. Total Fees&TuitionChargesof all siblings(PerMonth) Rs/-__________________ 22. Detailsof anyothersupportingpersonwhoisgivingyoua helpinghandinyoureducation. Name:___________________ Relation_____________ Cell # ________________ Amountbeingpaid_________ 23. If you or any othersiblingisgettingfinancial supportfromAlfalahoranyotherGovernmentorNon-government organizationgive itsdetails Name of Beneficiary:____________________ Organization __________________ Amount of Stipend _________ 24. Provide detailsof two personsasreferencestocertifyyour givendetails.The saidpersonsshouldbe educated and theyshouldbe well aware of yourfamilycircumstances 25. Certificationby the student and his/herfather/guardian It iscertifiedthatall particularsgiven above are correct. Student’sSignature ________________ Father’s/Guardian’sSignature __________________Date: ___________ 26. Certificationby the Head of Institution It iscertifiedthat above namedapplicantisbonafide studentof thisinstitutionandrecommendedforgrantof scholarshipbeingadeservingone. Name ______________________________________ Designation_________________________________ Signature ___________________________________ Date: _______________________________________ Office Stamp (Must be Readable) REFERENCES 1. Name:---------------------------------------------------- Profession/Occupation:--------------------------------- CNIC# ------------------------------------------------------ Cell # -------------------------------------------------------- 2. Name:---------------------------------------------------- Profession/Occupation:--------------------------------- CNIC# ------------------------------------------------------ Cell # -------------------------------------------------------- CERTIFICATION
  • 3. 3 ‫صفحہ‬ ‫(یہ‬‫صرف‬‫درخواست‬ ‫اسکو‬ ‫ہے‬ ‫لیے‬ ‫کے‬ ‫راہنمائی‬ ‫کی‬ ‫طلبہ‬‫فارم‬‫ساتھ‬ ‫کے‬‫لف‬)‫کریں‬ ‫نہ‬ This page is only for the guidance of applicants and not to be attached with application form. Attesteddocuments tobe attached 1. Photocopyof Self’sCNIC. 2. Photocopyof Father’s/Guardian’sCNIC. 3. 3 RecentPhotographs. 4. Photocopyof currentElectricityBill. 5. Photocopyof Father/Mother/Brother/Sister’sPensionBook/SalarySlip. 6. Photocopyof all previousexams’result. 7. Photocopyof fee slip(Lastsemester/year) 8. Hostel certificate (if applicable) 9. Bonafide Certificate (Mentioningcourse startandendingdates) Only those applicants may apply who are:- 1. Facingacute financial hardshiptocontinue theirstudies. 2. Having good academic record in last Board/University exam with minimum 70% marks (Matric) and 60% marks (Inter, DAE and above). Minorities 60% marks (Matric) and 55% marks (Inter, DAE and above). 3. Bonafide students of Govt. institutes. However students of intermediate class studying in a registered private institutions may apply. Note: Call on cell phone during office hours(9:00am – 5:00pm) avoid to call duringNAMAZ time please. Application form to be submitted to concerned region. Addresses are given below:- PUNJAB SINDH BALOCHISTAN Haris Nazir (Program Manager, Education) AlkhidmatFoundation Punjab Mansorah,Lahore Cell:0300-2440764 Ph: (Office) 042-35413038 Muhammad Hussain AlkhidmatFoundation Sindh Street # 3, Kaba Auditorium, Block 13 Federal B Area, Karachi Ph: (Office) 021-36344621 021-36345131 Muhammad Sadiq Mengal AlkhidmatFoundation Balochistan 165 Samungli HousingScheme Samangli Road Quetta Cell:0333-7929916 Ph: (Office) 081-2826115 KPK FATA KARACHI Muhammad Adil AlkhidmatFoundation Khyber Pakhtunkhwa B-39, Street # 6, Sikandar Town, G. T. Road Peshawar Cell:0316-1208337 Ph: (Office) 091-22613771 Hameed Afridi AlkhidmatFoundation FATA Safi Town Gulbahar No. 5 (Adjacent to Jamia Alhadia) Near Ring Road – Peshawar Cell:0333-9052327 Ph: (Office) 091-2262327 QasimRasheed AlkhidmatWelfare Society Karachi 504, Qaideen Colony, Near Islamia College, Karachi Cell:0333-2231446 Ph: (Office) 021-34915361-4 AJK GILGIT/ BALTISTAN Engr. Muhammad Khalid AlkhidmatFoundation AJK B-1, 2nd floor, Flat# 2, Noor Plaza, Chandani Chowk, Setlite Town Rawalpindi Atif Abbasi (ProgramManager) Cell:0346-5194373 Ph: (Office) 051-4421190 Tahir Rana AlkhidmatFoundation Gilgit& Baltistan Near China Trade Center Gilgit Cell:0346-9212525 Ph: (Office) 05811-457039 INSTRUCTIONFOR STUDENTS