Lahore University of Management Science                                            1 Photograph
Application form for National Outreach Programme
                    Batch-11                                                                         Paste here with glue
Who can apply?
Applicants should have atleast 80% MARKS IN MATRICULATION in order to apply for the NOP.
Moreover, NOP is a NEED BASED SCHOLARSHIP. Only genuinely financially deserving students will be
considered for the Programme.
 Instructions for the submission of application form:
 Please follow these instructions carefully:
      Fill in the form using a black pen.
      Fill the form in BLOCK LETTERS.
      Write your name and date of birth in the back of each picture.
      Fill the form completely; INCOMPLETE forms will not be processed.
      Attach all the required documents, application forms without Complete Documents will not be processed.
      Application Form along with all the required supporting documents should reach LUMS Admissions Office latest
       by February 03, 2011.
      CHECKLIST OF THE REQUIRED DOCUMENTS:
   Please mail all the required supporting documents (mentioned below) along with the application form in a
   single envelope to the mailing address given below in the box:
             Three attested latest passport size photographs
              Attested copy of Matriculation/O level result card
             Attested copy of National Identity Card (NIC) of your parents/guardian
             Income certificate of your parents/guardian*
   Note:
   * An income certificate is the document that shows monthly/annual income. If your parents/guardian are
   salaried, an original copy of a pay slip can be attached, otherwise if your parents/guardian own a business
   they can submit Bank Statement for the last six months. If parents/guardian does not fall in either of the
   above two cases (that is salaried employee or business man) they can submit an undertaking on a stamp
   paper/affidavit (of Rs.20) stating their income and income source.
   In case of providing false information, candidate will be disqualified and his / her application will not
   be considered.
   Mailing address is given below:
                                                                                                2 Photographs
   Ms. Bushra Tasleem
  Office of Admissions
  Lahore University of Management Sciences                                                        Staple here
  Opposite Sector U, DHA, Lahore Cantt. 54792
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PERSONAL DETAILS : (Please use BLOCK LETTERS to fill the form)
Forms with incomplete information will not be processed.
         Name:
         Father’s Name:                                                  Guardian’s Name:
                                                                         Date of Birth
         Father’s / Guardian’s NIC #:                                    (of student): ______/______/______
         (Provide a copy of NIC)                                                        dd    / mm / yy
         Mailing Address: (All future correspondence will be made on this address)
         CITY:                               DISTRICT:                            PROVINCE:
         Phone #:             /
                      (City code)                            Mobile #:
         Permanent Address: ( If different from the mailing address)
         CITY:                             DISTRICT:                                               PROVINCE:
         Phone #:             /
                      (City code)
         Email*:
         * It is mandatory for you to have a valid email address as well otherwise your form can be considered INCOMPLETE.
         Do you have internet access at home or near your              YES                    NO
         house?
EDUCATION
Attach an attested copy of all the result cards with your application form.
                                           Marks/ Grades     School / College
        Matric / O-level
        Intermediate / A-level 1st year
                                2nd year
        Stream Pre-Medical            Pre-Engineering     General Science        Arts/Commerce Other
Is any member of your family currently studying at LUMS?                          Yes    No         If yes, state name and roll number:
         Name                                                        Roll No:
                                                                                                              Page 2 of 5 
Give details about yourself and your siblings*:
*Siblings are brothers and sisters
                                                          School / College /        Annual                      Parents
                                                              University              Fee        Scholarships Contribution
                   Name                         Age       (If still studying)       (in Rs)         (in Rs)     (in Rs)
Give details of teacher / headmaster / principal of your institution who knows you personally.
   Name:                                            School:
   Address:__________________________________________                                     Tel:________/_____________
                                                                                                (city code)
   Email address:
FINANCIAL DETAILS
a. ASSESTS:           Houses, plots and other property owned by the family
                                                   Current Value        Area                    Location
           Assets Title         Asset              ( in Pakistan        ( in Kanals/Marlas
                                Ownership**        Rupees)              or Sq. Feet)
          i. House
          ii. Land / Plot
          iii. Agriculture
          iv. Commercial
        **In this column provide information about who owns the specific asset. It can be your father, mother, brother or
        grandfather etc.
                                                                                                              Page 3 of 5 
    b. INCOME
(Give annual figures for items i, ii, iii, iv v)
                                                                                                 Guardian’s / Brother’s
                         Income Source             Father’s             Mother’s                      & sister’s
              Profession
             i. Agricultural income
                   (Annual)
             ii. Salary / Pension
                   (Annual)
             iii. Returns on Saving
                 & Investment (Annual)
             iv. Rental
                  Income(Annual)
             v. Business            Income
                  (Annual)
              Total (I, ii, iii, iv & v)
                                              A:                   B:                       C:
              Total Income: (A+B+C)
              How many air-conditioners do you have in your house?
              Details of vehicle Owned by Family
               NO         Type of Vehicle                                      Make and Model
c. EXPENSES
           Annual Educational Expenses                                    Annual Medical Expenses
                                                                          Transportation / Food /
                                                                          Traveling Expenses / Other
           Annual Rent (If Living in a Rented House)                      Expenses ( per Annum)
           Annual Taxes                                                   Annual Electricity Bills
        Annual Telephone Bills                                            Annual Water/Gas Bills
d. LIABILITIES
               Are there any outstanding loans? Yes           No        If yes then:
                  i)         Please indicate the amount of loan in Rs.________________________.
                  ii)        And also please specify the purpose for taking the loan ___________________
                  iii)       The source from where loan was taken
                                 Bank *       Relative         Employer*               Other (Please Specify):
     * Kindly attached the supporting documents in case the loan is from Bank or Employer.
                                                                                                             Page 4 of 5 
TUITION EXPENSES:
                      Tuition Fee for the first year at LUMS is Rs 400,000/- approximately
                      Please Indicate the total amount of contribution you can make towards
                             your tuition fee annually at LUMS Rs________________
TEST CENTER:
              Please choose one of the following centers for Preliminary Evaluation Test
                    Gilgit            Peshawar      Rawalpindi          Lahore         Faisalabad              Multan
                    Quetta            Hyderabad         Karachi         Sukkur         Gujranwala              Skardu
Why do you require financial aid (Attach separate sheet if required)?
How did you get to know about National Outreach Program? (Tick any one of the following)
     Friends/Relatives                  Newspaper Add             LUMS website
     Information Session at School/College.
   Kindly mention the School/College Name where you attended the session:_________________________________________
     Other(Please Specify): ___________________________
     Undertaking:
     I certify that the information given on this form is accurate to the best of my knowledge. I
     understand that any misrepresentation may cause my dismissal from the Programme at any stage.
     ________________________                                                    ________________________
     Applicant’s Signatures                                                      Father/Guardian’s Signature
     Date: ______/______/______                                                  Date: ______/______/______
               dd      /     mm   /    yy                                               dd   /   mm   /   yy
     For enquiries regarding your application form contact us at:
     Phone: 042-35608000, ext: 2407
     Fax: 042-35898317, Email: nop@lums.edu.pk
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