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No

FRONTIER MEDICAL

& DENTAL COLLEGE

Date

ABBOTTABAD, PAKISTAN

Received by.

Admission Application Form for MBBS / BDS

1. Please indicate for which course you wish to apply:
2. Seat applied for: Open Merit
3. Boarder

Day Scholar

MBBS

BDS

Dual Nationalities

BOTH

Foreign National

Please tick () which ever you need.

4. Name: 5. Fathers Name:..

6. Full Postal Address:
.
Phone (Res): . E-mail :......(Mobile): ..
7. Date of Birth ............. 8. Place of Birth....... 9. Sex: .
10. Nationality 11. Domicile . 12. Religion .
13. Fathers or Guardians name, occupation/profession, exact position held & Postal Address:
Name: .. Profession / Occupation:
Exact Position held: ......
Permanent Address: .....

Phone (Res) (Mobile) ....E-mail......................

14. Education/Qualifications:
Qualifications

Year of
Passing

Marks
Obtained

Total
Marks

Name of the School / College

Name of the
Board/University

Matriculation:
(Secondary School)
F.Sc. Pre Med:
(Higher Secondary School)

Govt. Entrance Test

15.

Indicate your qualifications if other than F.Sc. like the British G.C.E A level or American
Board, SAT-II or similar qualifications / degrees .... Year of Passing ..
Subjects passed with grades ..............
School/College with address .

16. Any Special Achievement

(This form should be filled in capital letters)
Please ensure that the form is completely filled
17. Extra curricular activities: a. Hobbies:..............
b. Sports:..c. Debates:.....d. Literary:.
1

e. Computer Knowledge: Yes

detail:....No

18. Who will bear the cost of your education, name & relation: ................
His exact Occupation/Profession:..
Exact position held if in service:....
Full Postal Address:

Phone (Res) (Mobile)..E-mail: ..

19. Are you physically fit? Yes
20. Do you smoke? Yes

No

No

if no, mention the problem:..

if yes, how many cigarettes you smoke per week: .

21. Have you ever been convicted by any court of law: Yes

No

if yes, then when and what for:

22. Have you been vaccinated against;

MMR: Yes

No

Hepatitis- B: Yes

No

Hepatitis -C: Yes

No

If Yes where and when and for what? ...

.
23.

The following attested photo-copies of the certificates etc. should be attached with the
application:
a. A Copy of Detail Marks Certificate of the examination on basis of which admission is sought.
(F.Sc. pre medical or similar examination like the British G.C.E A level or American /
Canadian High School Board, SAT-II Certificates with grades etc.)
b. A copy of Secondary School Certificate Examination (Matriculation or O-Level)
c. A copy of the certificate of the Entry Test conducted by the provincial govt. of the province of
the domicile of the candidate.
d. A copy of National Identity Card or form B, whichever is applicable.
e. For Foreign and Overseas applicants photocopies of the relevant four pages of Passport.
f.

A copy of the Domicile / Residence Certificate.

g. A copy of Character Certificate from Head of the institution last attended.

h. A copy of any other educational achievement or co-curricular activity or certificate that an
applicant wishes to be considered in his favour.
i. A Medical Certificate duly signed by a registered medical doctor regarding physical fitness.
j. A certificate that you have received proper Hepatitis B & C vaccine.
k. Six Copies of passport size (2 x 2 inches) colour photographs of the applicant.
Candidates whose result has not yet been declared can also apply and submit the result
certificate after the result is declared.

24. Declaration by the applicant:

2

a. I, Mr./MissS/D/O...
declare that I have made the correct statements. If any statement is found false at any time I
shall be disqualified for admission and continuing studies.
b.
I shall fully abide by the college rules and regulations as at present and to be announced
by the college from time to time.
N.I.C. No.

or
Form-B No.
..
(Signature of the applicant)
(Passport No. in case of foreign applicants .........)
Issued on . at .
25. Declaration by Father / Guardian:
I, Mr./ Mrs. .
Father /guardian of .........
certify that my son / daughter / ward is applying for admission in MBBS/BDS course, at Frontier
Medical & Dental College, Abbottabad with my consent. He/she has made correct entries and I
endorse his/her declaration and agree to it. I undertake to arrange payment of his/her fees and other
dues regularly during the 1st month after start of each session without delay. I further assure that
myself and my son/daughter/ward shall strictly abide by the rules and regulations of the college. I
accept and agree to all the present and future rules and decisions of the college authorities.
N.I.C. No.

(Signature of Father/Guardian of the applicant)

(Passport No. in case of foreign applicants ..)
Issued on . at ......
26. Important Note:
This completed application form should be accompanied with a demand draft of Rs.3000.from within Pakistan and U.S. $ 100.- from foreign and overseas applicants in the name of
Frontier Medical & Dental College as the Admission Processing Fee and should be
submitted / mailed to the college address:
FRONTIER MEDICAL & DENTAL COLLEGE
Admission Office
P.O. PUBLIC SCHOOL, MANSEHRA ROAD
ABBOTTABAD PAKISTAN
Phone: 92-992-406600 / 406506, Fax: 92-992-406777
E-mail: info@fmc.edu.pk, Website: www.fmc.edu.pk