5, Khayaban-e-Johar, H-9, Islamabad - 44000. UAN: 111-264-264 Fax: +92-(0)51-443 8315 E-mail: admissions@iqraisb.edu.pk Web: www.iqraisb.edu.

pk
Form No. 12 -

Attach 4 Photographs
Fall 2012

APPLICATION FORM

Semester

To be completed by the applicant using capital letters.

1. Name
(as per SSC/O-Levels)

CNIC No. CNIC No. CNIC No. Single

M Y

2. Fathers Name 3. Guardians Name

(If other than Father)

4. Male

Female
D

Married Place of Birth (City) Nationality

Date of Birth

5. Current Address of Applicant

Permanent Address of Applicant

Tel (Res): E-mail Address:

Mobile:

Tel (Res):

Mobile:

6. Fathers/Guardians Occupation Fathers/Guardians Business Address Tel (Office): E-mail Address 7. Name & Telephone Number of person to be notified in case of emergency Name Telephone No(s). Address 8. Program Applied for (Tick the appropriate box)
Bachelor Programs Bachelor of Business Administration (BBA) Bachelor of Art in Fashion Design (BFD) Bachelor of Art in Textile Design (BTD) Bachelor of Science in Computer Science BS(CS) Bachelor of Science in Telecommunication and Networks BS(TN) Bachelor of Engineering in Electronic Engineering BE(EE) Bachelor of Science in Development Studies BS(DS) Bachelor of Science in International Relations BS(IR) Bachelor of Sciences in Social Science BS(Sc) DIPLOMA One year Diploma in Fashion/Textile Designing Two year Diploma in Fashion/Textile Designing

Fax No.

Mobile No.

Relationship with the Applicant Mobile No.

Master Programs Master of Business Administration (MBA, Morning) Master of Business Administration (MBA, Evening) Master of Science in Development Studies (MSDS) Master of Science in International Relations (MSIR) MS / MPhil Programs Master of Science in Management Science MS(MGT) Master of Science in Computer Science MS(CS) Master of Science in Software Engineering MS(SE) Master of Science in Telecommunication and Networks MS(TN) MPhil in International Development Studies MPhil in International Relations PhD Programs PhD in Management Science PhD in Computer Science PhD in Telecommunications and Networks P.T.O.

9 . Academic Record

Form No.

12 -

QUALIFICATION
Matric/O Level FA/FSc/A Level Bachelors Masters Other

BOARD/UNIVERSITY

YEAR

MARKS/CGPA
OBTAINED TOTAL

STATUS

COMPLETE COMPLETE COMPLETE COMPLETE

10. Have you qualified Entrance Exam of: If Yes, Name of the Exam Roll No. Year.

NTS

GRE

SAT

Marks. Yes No. Registration No.

Valid Upto.

11. Have you ever been student of IUIC before? If Yes: Program Reason for leaving 12. Are you currently employed ? Yes Designation Address No.

If Yes: Name of the Employer Telephone No. Yes . marks/CGPA. No.

Does your employer know about your admission at IUIC ? 13. For Result Awaiting Students only: I undertake that I am awaiting my result of from Board/Univesity

program in year Under Roll No

. I assure that I shall secure at least

After the declaration of the result I shall submit the Result /Equivalence Certificate immediately but not later than the commencement of classes of Fall-2012 Semester. I am fully aware that my admission will stand cancelled forthwith if I fail to submit the result/Equivalence Certificate with requisite percentage/CGPA within time.

I hereby affirm that:

14. All documents/information provided by me for admission in Iqra University are verified and correct. If any document/information is found fake or having incorrect information, University has the right to close my admission at any stage and degree/certificate obtained from Iqra University will be treated as cancelled.

Last Date to apply: July 11, 2012 Entry Test & Interview: July 14 & 15, 2012 at 10:00 am

Students Signature

for Official use

Admission Form Submission Date: ....................................Admission Form Received By:....................................... Receipt No. ....................................

Status of the Applicant: 1. Admission Approved 2. Admission Denied 3. Admission Pending Chairman of the Admission Committee: Name: Date:

Comments, if any:

Signature