QUAID-I-AZAM UNIVERSITY

APPLICATION FORM FOR

HEC NEED BASED SCHOLARSHIP
Name of Applicant_______________________________ S/O________________________________

Scholarship is based on assessment of need and merit as well as availability of funds. Selection will be
decided on the basis of information provided in this form and investigations for the authentication of
provided information. Candidate may be required to appear for interview (s).
PROVIDING FALSE INFORMATION
Providing false information may result in one or all of the following:
Cancellation of admission.
Rustication from the university.
Initiation of criminal proceedings.
Disqualification for award of any future loan/scholarship.
Refund of all the payment received and or a penalty equal to total scholarship amount.

INSTRUCTIONS FOR FILLING OUT THE SCHOLARSHIP APPLICATION FORM:

 Fill in the form using black ball point pen and write in capital letters
 Read the application form carefully.
 Complete the photocopy form and make sure everything is correct and final
 Copy all information from photocopied form to the original form
 Submit duly completed application form to the OSFA
 Furnish factual, comprehensive and authentic information in the form
 For family financial reporting parents/guardian may be consulted for guidance
 Whenever in doubt or lost, seek help from the Focal Person/Manager Financial Assistance
 Check your application for spellings, grammatical errors and factual oversight
 Keep a photocopy of the filled-in original application form for your record
 Ensure that you have attached all the required documents by putting a tick mark in checklist
 Answer all questions. Those not applicable should be marked “N/A”
 Affidavit Needs to be submitted after final selection of the candidate
Definitions:

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 Application Form Check List
SN Description Tick the
relevant
1 Copies of computerized NIC of
Father/Mother/Guardian
2 Income Tax Certificate
Father
Mother
Guardian
3 Copy of last Income Tax Return of
Father
Mother
Guardian
4 Salary Certificate of
Father
Mother
Guardian
5 Copies of last six (01) month utility bills (having whole year bill detail)
Electricity
Gas
Telephone
Water
6 Attested copy of rent agreement (if applicable)
7 Copies of last & latest fee receipts of self and siblings *
8 Copies of Medical bills/ expenditure related documents (if applicable)
9 Copies of pervious scholarship(s) attained (if applicable)
10 Statement of Purpose
* Siblings are brother & sisters Ed
Send your application by post or submit by hand to the Scholarship Aid office or focal person.
Place documents in right order as per above sections (1 to 10) u
Put all amounts in Pak Rs.
Do consult with parent(s)/guardian(s) for financial data accuracy & reliability c
For the information not present/relevant write in capital letters N/A
DO NOT: a
Provide False/vague/ incomplete information.
t

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 QUAID-I-AZAM UNIVERSITY
Degree Title / Program: M.Sc ______________ FALL 2012 (Regular)

Section A:
Applicant Personal and Family Information

1. Applicant’s Name: ____________________________________Gender: Male Female

2. University Reg. No:

3. Applicant NADRA - -
NIC No.
4. Marital Status Single Married Divorced
5. Age : _________ Place of Birth ____________________________________________
6. Present Address _________________________________________________________

7. Permanent Address: ______________________________________________________

________________________________________________________________________
8.
9. Tel (Res.): _____________________ Mobile: ___________________________________
10. Email: ___________________________________________________________________
11. Total Members in the Family: ________________________________________________
12. Total Family Members currently living with you: ____________________________________
13. Total Number of Brothers/Sisters married ______________________________________
S# Name of Family Member (s) Relationship Marital Status Remarks**
1
2
3
4
5
6

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**
14. Total Earning Members in Family: _____________________________________________
15. Details of Family Members Earning:
Monthly
S Family Family Member Organization
Relationship Designation Gross Remarks
# Member Name occupation *** Name
Pay/Earning
1

Total Monthly Family Income (add self income, if applicable) Pak Rupees
*** Family Member Occupation classification
1. Government Service (Specify the employment grade BPS/SPS/PTC etc.)
2. Private Job
3. Agriculture/Farming
4. Own Business (Self Employed). Details/nature of self business need to filled in at remarks column
5. Others. Details/nature of self business need to filled in at remarks column

16. Total No of family members not earning _______________________________________

17. Brothers/Sisters/Children/Family Members studying _____________________________
Details of Siblings Studying
Relation Tuition
S# Name with Name & Address of Institute Fee per month per month
applicant (If applicable)

1
2
3
4
5
6. Applicant Self Quaid-i-Azam University
Total Fees & Tuition Charges

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18. Father’s Name: _________________ Computerized N.I.C. No ________________________
19. Status: Alive Deceased
20. Professional status: Employed Retired Business Owner
21. Name of Company/Employer: ___________________________________________________
22. Address: ____________________________________________________________________
23. Tel (Off): ______________________________ Mobile: ______________________________
24. Occupation Type: ____________________________________________________________
25. Designation & Grade ( BPS/ SPS/PTC etc): ________________________________________
26. Total Gross Monthly Income (Salary/ Pension/ Others): _____________________
27. Total Net Monthly Take Home Income (Salary/ Pension/ Others): _______________________
28. Previous Occupation (if applicable): ______________________________________________
29. Total Annual Income: ___________________________NTN___________________________
30. Any Other Supporting Person (Mother/ Guardian/ Brother/ Sister/Family Relative/Guardian):
31. Name: ___________________________ Relationship: _________________________
32. Address: ____________________________________________________________________
33. Tel (Off/Res) _______________Mobile No._______________ NIC no.__________________
34. Occupation __________________________________________________________________
35. Designation_____________________Name of Company/Employer _____________________
36. Total Monthly Gross Income (Salary/ Pension/ Others) ___________________________
37. Total Net Monthly Take Home Income (Salary/ Pension/ Others): _______________________
38. Total Net Annual Income______________
39. Monthly Financial Support Available to Applicant in Pak Rs. ___________________________

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 40. Asset Income (on monthly basis)
S# Income Source Father Mother Spouse Self Other Total
1 Property Rent
2 Land Lease
3 Bank Deposits*
4 Shares / Securities*
5 Other (Specify)

Total
* For sources with annual income returns, kindly report the monthly income earned
41: Total Family Monthly Income
Monthly Income Monthly Gross Monthly Net
S# Family Member Name Relationship from Assets Pay/Earning (Take home)
Pay/Earning
1

5 Applicant Monthly Gross Pay/Earning

(Sec. 11)
6 Applicant Monthly Net (Take home)
Pay/Earning (Sec. 12)

Total Monthly Income in Pak Rupees

Total Annual Income in Pak Rupees

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FAMILY EXPENDITURES
42; Accommodation Expenditures
Type: Bungalow Apartment /Flat Town House Village House
Status: Rented Self or Family owned Employer / Govt Owned
Rent Payment: Self Employer/Govt Others
House Plot Size in Sq. ft._________________ Covered Area in Sq. ft._________________

Number Of
Accommodation Number Of Accommodation Accommodation
S# Air
Location /Address Bed Rooms Monthly Rent Annual Rent
conditioners
1-2 1-2
2-4 2-4
4-6 4-6
6-8 6-8
Above 8 Above 8

Total Accommodation Rental Expenditure

Any other house/flat owned by the Parents/Guardian (if yes please specify with location
and size)_______

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 ________________________________________________________
43: Utilities Expenditures
Last Month Utilities Paid
Telephone Electricity Gas Water

Average of Last Six Months (Per Month Utilities Charges)

S# Telephone Electricity Gas Water Total

1
44. Monthly Food /Kitchen Expenditures ________________________
45. Medical Expenditures: Average of last six months (Per Month Expenditure)
___________
46. Travelling/ Miscellaneous Expenditures
Average of last six months (Per Month Expenditure)_______________________________
Total Family Expenditures
Education Accommodation Utilities Food Medical Misc. Total Monthly Total Annual
S
Expenditure Expenditure Expenditure Expenditure Expenditure Expenditure Expenditure Expenditure
#

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Description Amounts in Pak Rupees

Total Monthly Income
Total Monthly Expenditure
Net Monthly Disposable Income*

Description Amounts in Pak Rupees

Total Annual Income
Total Annual Expenditure
Net Annual Disposable Income*

* If the monthly / Annual Disposable Income is negative, kindly explain the reasons for the gap, and
the arrangements through which the differential gap is met by the family

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 Section B:
Cumulative information of Self, Parents and Guardian Assets

Assets (with current market value)

48 Does the family own any Transport? Yes No
If yes kindly fill the relevant details

Ownership
S# Transport Type Make /Model Engine Capacity (CC) Registration No.
Period
(Car/ Motor cycle/ Others*)
1
2
3
4
* Others: include tractor, rickshaw, bi-cycle, motorcycle rickshaw, carriage pick, truck etc.
49 Number of Cattle(s) (with kind) ____________________________
50: Area and location of Land(s)/Plot(s) owned _________________________________________
Cultivable Agricultural
Assets Title Qty Size Location (Address) Area Yield per
Acre
Residential
Commercial

Agricultural
Employer/ Govt
Scheme

56. Assets worth (Current Market Value in Pak. Rs.)

S# Assets Title Father Mother Spouse Self Guardian Total
1 House
2 Business
3 Land & Building
4 Bank Balance
5 Stocks/Prize bond
Total
57. Taxes paid (per annum in Pak. Rs)________________________________________________

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 Section C:
Financial arrangements for current year

51. Funds Availability for Applicant Education (per annum in Pak Rupees)

S# Income Source Father Mother Spouse Self Other Total

1 Salary / Earnings
2 Family / Friend Advances
& Loan *
3 Bank Loan
4 Other (Specify)

Total

* Family/ Friend Loan

(Specify relationship with the relative / friend)

__________________________________________________________________________________

__________________________________________________________________________________

52 Any source of financing other then this scholarship (Please specify)______________________

__________________________________________________________________________________

__________________________________________________________________________________

53 How were the admission /first semester charges paid?

__________________________________________________________________________________

__________________________________________________________________________________

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 Section D:
Applicant Educational Record

Name and Location of Per Month To- From Division/ %age /

Level of Study month/ yr.
Institute Fee GPA/ CGPA
Bachelors Grade
Intermediate
Secondary

54 Per
month fee/ tuition charges of the institution last attended ________________________
55 Hav
e you ever awarded any other scholarship before: Yes No
(If yes fill the details of scholarships & attach documentary proof of the scholarships)

Total Total Class / Level at which

Scholarship Scholarship was
S# Name of Institute Scholarship Scholarship
Name granted
Amount Period
1
2
3

Statement of Purpose (Explain your suitability for this scholarship) - attach separate sheet if required
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
56 UNDERTAKING
1. The information given in this application is true to the best of my knowledge and I understand that any incorrect
information will result in the cancellation of this application. If any information given in this application is found
incorrect or false after grant of Scholarship, the University will stop further assistance and the student will have to
refund all payment received and penalty equal to total scholarship amount received.

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2. University reserves the right to use information given in this form for verification and other purposes.
Date: Date:
Date: Parents / Guardian Signature ___________________ Applicant Signature: ______________________________

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 For Official use only

Are the applicant documents in order? Yes No

The notices furnished to the applicant for furnishing of required documentation
Document
S# Notice Date Document Name Missing Remarks
Submission Date
1
2
3
4
Application Case Review Dates (i) _________________(ii) _________________________________
Additional Remarks

Remarks/recommendations of the Chairpersons

______________ _______________ ___________________________________

Date Department Name Signature Head of Department / Focal Person