Session2015-16

APPLICATION FOR SCHOLARSHIP

3 Photos RequiredSize (2 x 1.5) (Submission Date 1st Aug 31st Oct) REGION: _____________________Note:1. Incomplete/late received applications will not be entertained.2. Applicants having 70 % and above marks in their last Board Exam will only be eligible to apply. However Minority students having 60 % marks 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 # 4. 7. (For office use) Diary # ______________________ Reg. #_____________________

CATEGORY ( Tick the relevant)Orphan Disable Need basedRELIGION ( Tick the relevant) Muslim Non-Muslim

APPLICANT PERSONAL INFORMATION1. Applicants Name: ______________________________ 2. Fathers Name: _______________________________3. Applicants CNIC No4. Fathers CNIC No----

5. Cell # (student): 1)___________________2) ___________________ 6. Cell # (Father): ______________________7. Date of birth: _____/____/_________Email: __________________________________ Tel (Res.) ______________8. Present Address: ________________________________________________________ District:_______________9. EDUCATION INFORMATIONPermanent Address: _____________________________________________________ District:_______________

10. Class ___________________ Course of Study ___________________ Year/Semester______________________11. Institution__________________________________________________ Contact No.________________________12. Course start date:_____________Course end date: ________________ Any distinction _____________________ 13. Monthly Fee: _________________________ Hostel Expenses: _________________________________________14. PREVIOUS EDUCATION RECORDName of Teacher __________________________________________ Contact No.__________________________15. DegreeYearTotal MarksMarks ObtainedPercentage

Matriculation

Intermediate

FAMILY & FINANCIAL INFORMATION15. Fathers/Guardians Name:_____________________________________ Profession:________________________16. Monthly Income: _____________________________________ Other source of income: ____________________17. Property/Land detail: __________________________________Cell # (Guardian): __________________________18. Fathers/Guardians professional status: Govt. Employee Private Employee Self-Business Retired Abroad Un-Employed Disabled 19. If Father/Guardian is employed complete the given sub sections: a. Name of Department /Company/Employer: _________________________________________________b. Address: _____________________________________________________________________________c. Tel (Off): _______________________________ Designation & Grade ___________________________d. In case of Self-Business, mention nature of business __________________________________________20. Total Monthly Income (Salary/ Pension/ Others): Rs:________________________________________________ (Attach the relevant proof i.e pay slip, copy of pension book etc.)21. Mothers Status: : Alive Deceased a. Marriage Relationship: CombinedSeparated/Divorced b. Professionals Status: Working Not Working 22. If Mother/Brothers/Sisters are serving then give details (Plz attach extra page if more than one siblings are serving)a. Name __________________________________________Cell #: ________________________________b. Name of Department /Company/Employer: _________________________________________________c. Address: _____________________________________________________________________________d. Tel (Off): ________________________________ Cell #: (Employer)__________ ____________________e. Designation & Grade ______________________ Total Monthly Salary____________________________ (Attach the relevant Proof i.e pay slip, copy of pension book etc.)23. If Father /Brothers are shopkeepers give detail of Shop (Nature of Shop/Volume of Shop) ___________________Total monthly income Rs: _______________________________________________________________________24. Fathers/Brothers Bank Account details (Bank Balance) _______________________________________________25. Mothers Gold Jewelry detail (Total Weight) ________________________________________________________26. Total Members in the Family: No. of students in family: (Applicant, his parents, brothers and sisters will be considered as family)27. Details of Siblings Studying including the applicants own detailSr. #NameGenderClass/CourseSemesterEducational Institute with AddressType of Institute(Govt./Private)Total Fee Per Month

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(In case you have more details to enter please use extra page)28. Total Fees & Tuition Charges of all siblings (Per Month) ______________________________________________

29. Details of any other supporting person who is giving you a helping hand in your education.S NoNameRelationContact NoAmount being paid

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30. If you or any other sibling is getting financial support from Alfalah or any other Government or Non-government organization give its detailsS NoName of BeneficiariesOrganizationAmount of Stipend

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REFERENCES

31. Provide details of two persons as references to certify your given details. The said persons should be educated and they should be well aware of your family circumstances

1. Name:-----------------------------------------------------------------------------------------------------------------------------------------

Profession/Occupation:------------------------------- CNIC #

Cell No:--------------------------------------------------------- Landline No:----------------------------------------------------------------Address (where meeting with the person is possible):------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------2. Name:-----------------------------------------------------------------------------------------------------------------------------------------

Profession/Occupation:----------------------------- CNIC #

Cell No:--------------------------------------------------------- Landline No:----------------------------------------------------------------

CERTIFICATIONAddress (where meeting with the person is possible):------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

32. Certification by the student and his/her father/guardianIt is certified that all particulars given above are correct.Students Signature _________________________ Fathers/Guardians Signature ____________________Date: ____________________________________Date: ________________________________________33. Certification by the Head of InstitutionIt is certified that above named applicant is bonafide student of this institution and recommended for grant of scholarship being a deserving one.

Office Stamp (Must be Readable)Name ______________________________________ Designation _________________________________Signature ___________________________________Date: ______________________________________

INSTRUCTION FOR STUDENTS

( )This page is only for the guidance of applicants and not to be attached with application form.

Attested documents to be attached1. Photocopy of Selfs CNIC.2. Photocopy of Fathers/Guardians CNIC.3. 3 Recent Photographs.4. Photocopy of current Electricity Bill.5. Photocopy of Father/Mother/Brother/Sisters Pension Book/Salary Slip.6. Photocopy of all previous exams result.7. Photocopy of fee slip (Last semester/year)8. Hostel certificate (if applicable)9. Bonafide Certificate (Mentioning course start and ending dates)10. Iqrar Nama (to be downloaded from Alfalah website www.alfalahss.org Applicants of intermediate, DAE, BA, BSc, B.Com will attach Iqrar Nama on plain paper (A4) while students of BS(H), MS, Masters, MBBS, BSc Engineering, LLB etc will send the Iqrar Nama on stamp paper worth Rs./100 dully attested by the Notary Public/Oath Commissioner as and when asked by the office i.e. after approval of their application for grant of scholarship. Only those applicants may apply who are:-1. Facing acute financial hardship to continue their studies.2. Having good academic record in last Board/University exam with minimum 70% marks.(Minorities 60 %) 3. Bonafide students of Govt. institutes. However students of intermediate class studying in a registeredprivate institutions may apply.Application form to be submitted to concerned region. Addresses are given below:-PUNJABSINDHBALOCHISTAN

Syed Zia Ullah ShahAlkhidmat Foundation PunjabMansorah, LahoreSyed UllahCell: 0303-8767449Ph: (Office) 042-35413038 Muhammad HussainAlkhidmat Foundation SindhStreet # 3, Kaba Auditorium, Block 13Federal B Area, KarachiPh: (Office) 021-36344621 021-36345131Muhammad HussainAlkhidmat Foundation BalochistanFlat # 7-8, Al-Musawir PlazaBurgainza Dalaz, Zarghoon Road,QuetaCell: 0344-8001541Ph: (Office) 081-2826115

KPKISLAMABADKARACHI

Waheed UllahAlkhidmat Foundation Khyber PakhtunkhwaB-39, Street # 6, Sikandar Town,G. T. Road PeshawarCell: 0334-9035941Ph: (Office) 091-2263651-52Sajjad Zaheer MalikAlkhidmat Foundation Islamabad B-4 first floor, Street # 31, Sector F-7/1IslamabadCell: 0300-8561491Ph: (Office) 051-2611911Qasim RasheedAlkhidmat Welfare Society Karachi 504, Qaideen Colony, Near Islamia College, KarachiCell: 0333-2231446Ph: (Office) 021-34915361-4

AJKFATAGILGIT/ BALTISTAN

Engr. Muhammad KhalidAlkhidmat Foundation AJK B-1, 2nd floor, Flat # 2, Noor Plaza, Chandani Chowk, Setlite TownRawalpindiCell: 0300-9184577Ph: (Office) 051-4421190Hameed AfridiAlkhidmat Foundation FATA Shenwari Sarai Dilazak Road,PeshawarCell: 0333-9052327Ph: (Office) 021-2602422Mujeeb RehmanAlkhidmat Foundation Gilgit & BaltistanNear China Trade CenterGilgit Cell: 0340-6197984Ph: (Office) 05811-457039

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