Student Registration Form 2011

8/3/2019 Student Registration Form 2011

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(PartA)Page[1]of[4]

FormNumber:(ForOfficialuseonly

PrimeMinistersNationalICTScholarshipProgram2011(PMNICTSP2011)NationalICTR&DFund,MinistryofInformationTechnology

GovernmentofPakistan

StudentsRegistration/ScholarshipApplicationForm

ImportantInstructions:

Thisform

has

two

parts

i.e.,

Part

A

&

Part

B.

Read

all

instructions

carefully

and

in

their

entirety

before

filling

out

and

submittingthisform.

InstructionforPartA:

1. Submission of PartA is mandatory for Registration/Scholarship. All eligible applicants are required to register withNationalICTR&DFundtobepotentiallyeligibleforscholarship.

2. Applicants are required to submit duly filled students Registration/Scholarship Application Form (PartA) directly bypostalmail to the following address not later than Saturday, 29October 2011. This form could alsobe submitted to

RepresentativesofNationalICTR&DFundnotlaterthanthedeadlineadvisedbythem.Itisthesoleresponsibilityofthe

applicanttoensureontimedeliveryofStudentsRegistration/ScholarshipApplicationFormtothefollowingaddressby

meansoftheirchoice.

ManagerPMNICTSP2011

NationalTesting

Service

(NTS)

HouseNo.402,StreetNo.34

SectorI8/2,Islamabad

InstructionsforPartB:

1. Applicantswhohavealreadysecuredadmission intheparticipatinguniversityarerequiredtosubmitPartBalongwithPartAwithin7daysfromthedateofsecuringadmissioninoneoftheparticipatinguniversities.

2. Applicantswhohavenotyet securedadmission inaparticipatinguniversityare required to submit PartB, separatelywithin 7 days from the date of securing admission in one of the participating universities. PartB of this students

Registration/Scholarship Application Form can be detached for later submission after securing admission in the

participatinguniversity.

3. ItisthesoleresponsibilityoftheapplicanttoensureontimedeliveryofStudentsRegistration/ScholarshipApplicationForm(PartB)totheaddressmentionedabove.

GeneralInstructions:

1. Formscanbephotocopiedormaybedownloadedfromwww.ictrdf.org.pk/scholarship.2. Listofparticipatinguniversitiesisavailableatwww.ictrdf.org.pk/scholarship.3. Applicantsareinstructedtosubmitonlyone(01)StudentsRegistration/ScholarshipApplicationFormfortheyear2011

Submission of multiple forms from a single applicant shall not be entertained and could result in cancellation o

registration/application.

4. Itisthesoleresponsibilityoftheapplicanttostay informedaboutPMNICTSP2011,participatinguniversities,universityselection criteria and entrance exam dates.Applicants are required to secure admissions in one of the participating

universitiestobepotentiallyeligibleforthescholarship.

5. The contact details as filled in the Students Registration/Scholarship Application Form will be used for futurecorrespondence.

It

is

advised

that

the

contact

numbers

(Landline/Mobile)

should

not

be

changed

during

the

course

of

the

PrimeMinistersNationalICTScholarshipProgram2011.6. Any queries pertaining to the Scholarship Program may be forwarded to [email protected] . For further information

applicantsmayalsocontactatthesehelplinenumbers:03365541183,03135771254

7. Applicantsarerequiredtovisitwww.ictrdf.org.pk/scholarshipforimportantinformationandregularupdates.8. All instructionsprovided inthisStudentsRegistration/ScholarshipApplicationFormareexclusively forPrimeMinisters

NationalICTScholarshipProgram2011.

9. NICTSPscholarshipholdersandawardeesofpreviousyearsarenoteligibletoapplyforPrimeMinistersNationalICTScholarshipProgram2011.

10.OnlythisformisvalidastheStudentsRegistration/ScholarshipApplicationFormfortheyear2011.


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(PartA)Page[2]of[4]

PARTA

INSTRUCTIONSTOFILLPARTA:

1. UseCAPITALlettersandleavespacesbetweenwords.2. Writedetailsexactlyastheyappearinyouracademicrecordsanddonotuseabbreviations.3. Affixrecentpassportsizecolourphotograph.4. Applicantsmustattachattestedcopiesofmatriculation&F.Sc.PartImarkssheets.5. ApplicantswhoseF.Sc.PartImarkssheetdoesnothavethenameoftheirrespective

school/collegemustsubmitaschool/collegecertificateaffirmingthattheyareregularstudentsof

thesaid

school/college.

6. Incomplete,illegibleorimproperlyfilledregistrationformsshallnotbeprocessed.7. ApplicantsmustfulfillbothAcademic&FinancialEligibilityCriteriaforregistrationpurpose.1.ACADEMICELIGIBILITYCRITERIA:

Pleasereadthefollowingstatementscarefullyandtick()theappropriatebox.a) HaveyoueitherpassedorappearedinF.Sc.ExaminationwithMathematics&Physics Yes No

in2010or2011?

b) Haveyouobtained60%orabovemarksinyourMatriculation(ScienceGroup)exam? Yes No

c)

Haveyou

attended

F.

Sc.

classes

as

aregular

student

from

aSchool/College

registered

Yes

No

withNationalICTR&DFund?(Listofregisteredschools/collegesisavailableathttp://www.ictrdf.org.pk/scholarship)

If your reply is Yesfora,b& cabove, thenproceedfurther.Otherwise, youarenoteligiblefor registrationanscholarship.2.FINANCIALELIGIBILITYCRITERIA:

1. Individualsbelonging to ahousehold,who are livingunder the same roof and their sustainabilitydependson the tothouseholdincome,shallbeconsideredafamily.

2. Applicant,belongingtoa familyearning lessthanRs.30,000permonth,shallbeeligibletoapplyforthePrimeMinisteNationalICTScholarshipProgram2011,regardlessofthetotalnumberoffamilymembers.

3. Applicant, belonging to a family earning more than Rs.60,000 per month shall not be eligible to apply for the PrimMinistersNationalICTScholarshipProgram2011,regardlessofthetotalnumberoffamilymembers.

4. Financialeligibilityoftheapplicantshallbecalculatedbasedonthefollowingtable:TotalFamilyMembers TotalMonthlyIncome(Rs.) TotalFamilyMembers TotalMonthlyIncome(Rs.)

3orLess Lessthanorequalto30,000 7 Lessthanorequalto50,000

4 Lessthanorequalto35,000 8 Lessthanorequalto55,000

5 Lessthanorequalto40,000 9ormore Lessthanorequalto60,000

6 Lessthanorequalto45,000

5. Totalelectricitybillforthelast06monthsshouldnotexceedRs.24,000/.Pleasereadfinancialeligibilitycriteriaasgivenaboveandproviderequisiteinformationbelow.

a) SourceofFamilyIncome: Salaried NonSalaried Both

b) TotalFamilyMembers:

c) TotalMonthlyIncomeofthefamily(Rs.):

d) TotalElectricityBillforlastsix(06)months(Rs.):

e) DoyousatisfyFinancialEligibilityCriteriaasgivenabove? Yes No

(DontStaple)

Affixrecent

passportsize

colour

photograph

withglue


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(PartA)Page[3]of[4]

3.PERSONALINFORMATION:

a) NameinFull:

b) CNIC#: (WriteyourownCNICNo.orBFormNo.)

c) FathersName:

d) FathersCNIC#: (WriteyourfathersorguardiansCNICNumbe

d

d

m

m

y y y y

e) DateofBirth: f) Gender: Male Femal

(AreaCodeTel.Numberforexample01572919456) (Keepthisnumberactiveforcorrespondenc

g) TelephoneNo.: Mobile: 0 3

h) Email:

i) PostalAddress:

j) UnionCouncil:

k) City/Town/Village:

l) Tehsil/Taluka:

(ProvideAgencyNameincaseofFATA)

m) District/Agency:

n) Province/Region: Punjab Balochistan Islamabad(Rur

Sindh

FATA

KhyberPakhtunkhwa GilgitBaltistan

4.ACADEMICINFORMATION:

a) SixdigitsSchool/CollegeCodeassignedbyNationalICTR&DFund:

(Forcode, askyourrespectivePrincipalorvisitwww.ictrdf.org.pk/scholarshipordialhelpline03365541183,03135771254)

b) SCHOOL/COLLEGEATTENDEDDURINGF.Sc.: School/CollegethatsubmittedyourdocumentsforF.Sc.finalexamtotheBISE(BoardofIntermediateandSecondaryEducation)School/CollegeName:

c) NameofPrincipal:

(AreaCode TelephoneNumbere.g. 023456543)

d) School/CollegeContactNo.


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e) School/CollegeAddress:

f) UnionCouncil:

g) City/Town/Village:

h) Tehsil/Taluka:(ProvideAgencyNameincaseofFATA)

i)

District/Agency:

j) Province/Region: Punjab Balochistan Islamabad(Rura

Sindh FATA

KhyberPakhtunkhwa GilgitBaltistan

k) ACADEMICRECORDS:

Certificate/Degree RollNo. Yearof

Passing

Total

Marks

Obtained

Marks

%age AcademicBoard

Matriculationor

Equivalent

(ScienceGroup)

F.Sc.PartI(WithMaths&Physicsascompulsorysubjects)

F.Sc.PartII(Ifavailable)

5.UNDERTAKING:

It is solemnly affirmed that all the information provided herein this Students Registration/Scholarship Application Form

correct.Ifanyinformationcontainedhereinisfoundtobeuntrue,Ishallbeliabletoanydisciplinaryactionincludingrejecti

of thisStudentsRegistration/ScholarshipApplicationFormorcancellationofScholarship/financialassistancebyNational I

R&DFundforPrimeMinistersNationalICTScholarshipProgram2011.Ifapproved,IshallusethisScholarshipuptothebestmy

knowledge

and

abilities

and

after

completion

of

studies;

Ishall

serve

my

country

for

at

least

two

years.

I further affirm that I have read, understood and shall abide by all the instructions provided in this Studen

Registration/ScholarshipApplicationForm.

I also understand and agree that all decisions made by National ICT R&D Fund related to Prime Ministers National IScholarshipProgram2011wouldbefinalandbindinguponme.

ATTESTATIONBYGAZZETTEDOFFICE

ApplicantsSignature

Name:

Fathers/GuardiansSignature

Stamp

&

Signature:

CNIC Number:

PLEASENOTE:AnyinformationbytheApplicantprovidedinthecourseofobtainingScholarshipshallbeaccurate,withoutomissionofanyrelevantfactsandn

misleading.IfanysignificanterrorsoromissionsintheinformationsuppliedinacquiringScholarshiparefound,Applicantshallnotbeoffereda

Scholarship,orhe/shewillhaveScholarshipwithdrawnorterminated.ForverificationandotherpurposespertinenttothePrimeMinistersNationalICTScholarshipProgram2011,Applicantsinformationwillbesharedwithrelevantauthoritiesandrelatedpersonnel.

NationalICTR&DFund(Company)reservestherighttoamendoralteranyofthetermsandconditionswithrespecttothePrimeMinistersNationalICTScholarshipProgram2011(Program).FinaldecisionspertainingtotheProgramrestwiththeCompany.


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(PartB)Page[1]of[2]

PARTB

INSTRUCTIONSFORSUBMISSIONOFPARTB: FormNo.___________

(ForOfficialuseon

1. Applicants who have already secured admission in the participating university are required tosubmit PartBalongwithPartAwithin7days from thedateof securingadmission inoneof the

participatinguniversities.

2.Applicants

who

have

not

yet

secured

admission

in

a

participating

university

are

required

to

submit

PartB, separately,within 7days from thedateof securing admission inoneof theparticipating

universities.PartBofthisStudentsRegistration/ScholarshipApplicationFormcanbedetachedfor

latersubmissionaftersecuringadmissionintheparticipatinguniversity.

3. ItisthesoleresponsibilityoftheapplicanttoensureontimedeliveryofStudentsRegistration/ScholarshipApplicationForm(PartB)tothefollowingaddress:

ManagerPMNICTSP2011

NationalTestingService(NTS)

HouseNo.402,StreetNo.34

SectorI8/2,Islamabad

4. Applicantswhohavesecuredadmissioninoneoftheparticipatinguniversitiesmaycontactthesehelplinenumbersforfurtherinformation:03015363211and03415766186

INSTRUCTIONSTOFILLPARTB:

1. UseCAPITALlettersandleavespacesbetweenwords.2. Writedetailsexactlyastheyappearinyouracademicrecordsanddonotuseabbreviations.3. Affixrecentpassportsizecolourphotograph.4. Incomplete,illegibleorimproperlyfilledregistrationformsshallnotbeprocessed.1.PERSONALINFORMATION:

a)

Namein

Full:

b) CNIC#: (WriteyourownCNICNo.orBFormNo.)

c) FathersName:

d) FathersCNIC#: (WriteyourfathersorguardiansCNICNumber)

d d m m y y y y

e) DateofBirth: f) Gender: Male Fema

(AreaCodeTel.Numberforexample01572919456) (Keepthisnumberactiveforcorrespondence)

g) TelephoneNo.: Mobile: 0 3

h) Email:

2.ADMISSIONINFORMATIONOFAPPLICANTINPMNICTSP2011PARTICIPATINGUNIVERSITY:

1. Applicants are required to provide information about one of the participating universities inwhich they have securadmissioninICTrelateddisciplineunderFall2011intake.

2. ProvisionofmultipleICTrelateddisciplinesorparticipatinguniversitiescouldresultincancellationoftheForm.3. Securingadmissioninaparticipatinguniversityisnoguaranteeofawardofscholarshipduetovariousreasonsincludi

students performance in university admission test, provision of limited number of seats by participati

(DontStaple)

Affixrecent

passportsize

colour

photograph

withglue


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(PartB)Page[2]of[2]

university/campus, university admission criteria/policy, prior academic performance, provincial population quot

limitedfundsandcriteriadevisedbyNationalICTR&DFund,etc.

4. ApplicantisrequiredtoattachattestedcopyofvalidadmissionletterissuedbytheUniversityofhis/herchoice,ifavailablPleasereadinstructionsasgivenaboveandproviderequisiteinformationbelow:

a) UniversityName:

b) Campus:

c) City:

d) ICTrelateddiscipline:

e) DateofAdmission:

f) AdmissionTestScore/MeritRating:

3.ATTESTATIONBYAUTHORIZEDREPRESENTATIVEOFSELECTEDUNIVERSITYASMENTIONEDABOVE:

Name: Signature&Stamp:

Designation: Date:

4.UNDERTAKING:

It is solemnly affirmed that all the information provided herein this Students Registration/Scholarship Application Form

correct.Ifanyinformationcontainedhereinisfoundtobeuntrue,Ishallbeliabletoanydisciplinaryactionincludingrejecti

of thisStudentsRegistration/ScholarshipApplicationFormorcancellationofScholarship/financialassistancebyNational I

R&DFundforPrimeMinistersNationalICTScholarshipProgram2011.Ifapproved,IshallusethisScholarshipuptothebestmyknowledgeandabilitiesandaftercompletionofstudies;Ishallservemycountryforatleasttwoyears.

I further affirm that I have read, understood and shall abide by all the instructions provided in this Studen

Registration/ScholarshipApplicationForm.

I also understand and agree that all decisions made by National ICT R&D Fund related to Prime Ministers National IScholarshipProgram2011wouldbefinalandbindinguponme.

ATTESTATIONBYGAZZETTED OFFICE

ApplicantsSignature

Name:

Fathers/GuardiansSignature Stamp&Signature:

CNIC Number:

PLEASENOTE:

AnyinformationbytheApplicantprovidedinthecourseofobtainingScholarshipshallbeaccurate,withoutomissionofanyrelevantfactsandn

misleading.IfanysignificanterrorsoromissionsintheinformationsuppliedinacquiringScholarshiparefound,Applicantshallnotbeoffered

Scholarship, or he/she will have Scholarship withdrawn or terminated. For verification and other purposes pertinent to thePrimeMinisteNationalICTScholarshipProgram2011,Applicantsinformationwillbesharedwithrelevantauthoritiesandrelatedpersonnel.

National ICTR&DFund(Company)reservestherighttoamendoralteranyofthetermsandconditionswithrespecttothePrimeMinisteNationalICTScholarshipProgram2011(Program).FinaldecisionspertainingtotheProgramrestwiththeCompany.

Documents

Student Registration Form 2011