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APPLICATION FOR SCHOLARSHIP

(Submission Date 1st Aug 31st Oct)


REGION: _____________________

Session
2015-16

Note:
3 Photos
1. Incomplete/late received applications will not be entertained.
2. Applicants having 70 % and above marks in their last Board Exam will only beRequired
eligible to
apply. However Minority students having 60 % marks can apply.
Size (2 x
3. Students studying in lavish institution will not be entertained.
1.5)
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

Muslim

Non-Muslim

Need based
RELIGION ( Tick the relevant)
APPLICANT PERSONAL
1. Applicants Name: ______________________________ 2. Fathers Name:
_______________________________
3. Applicants CNIC No
-

4. Fathers CNIC No
-

5. Cell # (student): 1)___________________2) ___________________ 6. Cell # (Father):


______________________
7. Date of birth: _____/____/_________Email: __________________________________ Tel (Res.)
______________
8. Present Address: ________________________________________________________
District:_______________
9. Permanent Address: _____________________________________________________
District:_______________
EDUCATION
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.Name of Teacher __________________________________________ Contact
No.__________________________
15.
PREVIOUS EDUCATION
1

Degree

Year

Total Marks

Marks
Obtained

Percentag
e

Matriculation
Intermediate

FAMILY & FINANCIAL


15.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: Combined
Separated/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)
_______________________________________________
2

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 detail
Class/Cours
e

Semest

Name

Gender

Sr.
#

Educational Institute
with Address

Type of
Institute
(Govt./Privat
e)

Total
Fee Per
Month

1
2
3
4
5
6
(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
No

Name

Relation

Contact No

Amount being
paid

1
2

30.If you or any other sibling is getting financial support from Alfalah or any other Government
or Non-government organization give its details
S
No
1

Name of Beneficiaries

Organization

Amount of
Stipend

REFERE
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:---------------------------------------------------------------Address (where meeting with the person is
possible):----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------CERTIFICA
32.
Certification by the student and his/her father/guardian
It is certified that all particulars given above are correct.
Students Signature _________________________
Fathers/Guardians Signature
____________________
Date: ____________________________________
Date: ________________________________________
33.
Certification by the Head of Institution
It is certified that above named applicant is bonafide student of this institution and
recommended for grant of scholarship being a deserving one.
Name ______________________________________
Designation _________________________________
Signature ___________________________________
Office Stamp (Must be Readable)
Date: ______________________________________

( FOR

INSTRUCTION

This page is only for the guidance of applicants and not to be


attached with application form.

Attested documents to be attached


1. 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 registered
private institutions may apply.
4

Application form to be submitted to concerned region.


Addresses are given below:PUNJAB
Syed Zia Ullah Shah
Alkhidmat Foundation
Punjab
Mansorah, Lahore
Syed Ullah
Cell: 0303-8767449
Ph: (Office) 042-35413038

SINDH
Muhammad Hussain
Alkhidmat Foundation Sindh
Street # 3, Kaba Auditorium,
Block 13
Federal B Area, Karachi
Ph: (Office) 021-36344621
021-36345131

KPK
Waheed Ullah
Alkhidmat Foundation
Khyber Pakhtunkhwa
B-39, Street # 6, Sikandar
Town,
G. T. Road Peshawar
Cell: 0334-9035941
Ph: (Office) 091-2263651-52
AJK
Engr. Muhammad Khalid
Alkhidmat Foundation AJK
B-1, 2nd floor, Flat # 2, Noor
Plaza, Chandani Chowk,
Setlite Town
Rawalpindi
Cell: 0300-9184577
Ph: (Office) 051-4421190

ISLAMABAD
Sajjad Zaheer Malik
Alkhidmat Foundation
Islamabad
B-4 first floor, Street # 31,
Sector F-7/1
Islamabad
Cell: 0300-8561491
Ph: (Office) 051-2611911
FATA
Hameed Afridi
Alkhidmat Foundation FATA
Shenwari Sarai Dilazak Road,
Peshawar
Cell: 0333-9052327
Ph: (Office) 021-2602422

BALOCHISTAN
Muhammad Hussain
Alkhidmat Foundation
Balochistan
Flat # 7-8, Al-Musawir Plaza
Burgainza Dalaz, Zarghoon
Road,
Queta
Cell: 0344-8001541
Ph: (Office) 081-2826115
KARACHI
Qasim Rasheed
Alkhidmat Welfare Society
Karachi
504, Qaideen Colony, Near
Islamia College, Karachi
Cell: 0333-2231446
Ph: (Office) 021-349153614
GILGIT/ BALTISTAN
Mujeeb Rehman
Alkhidmat Foundation Gilgit
& Baltistan
Near China Trade Center
Gilgit
Cell: 0340-6197984
Ph: (Office) 05811-457039