HIGHER EDUCATION COMMISSION

www.hec.gov.pk/balochistan-fata
H-9, ISLAMABAD (PAKISTAN)

Attach Photograph here (2-Photos, Put Name and Attestation at the back)

PROVISION OF HIGHER EDUCATION OPPORTUNITIES FOR STUDENTS OF BALOCHISTAN AND FATA

APPLICATION FORM FOR 4-YEARS UNDERGRADUATE PROGRAM

(i.e: B.E/B.Sc (Engineering), MBBS, BDS, BBA, B.Com (Hons.), B.Pharmacy, BCS, BSc (Hons.) etc.)

Instructions to fill the form:

1.
2. 3. 4. 5.

7.

Type the Application Form using Microsoft word OR write in CAPITAL LETTERS using Black Ink. Incomplete Form will not be considered. Do not leave any column blank, if Not Applicable please write N/A. Do not overwrite or cross any information on the form. Attach photocopies of all educational testimonials with the form. 6. An amount of Rs. 500/- as application processing and test fee (non refundable) may be deposited in the HEC Online A/C No. 17427900133401 in Habib Bank Limited, Shalimar Recording Company Branch, H-9, Islamabad. Send us original bank receipt. (Photocopy of the bank receipt or any other form of payment is not acceptable).

Eligibility Criteria
a b Is your age less than or equal to 22 Years on 13th August 2010 Have you obtained 60% Marks in F.A/F.Sc/A-Level/Equivalent Yes Yes No No

If a and b both are Yes then proceed further

Bank Slip Details

Original Bank Slip worth Rs. 500/- No: ____________________ Drawn on Bank: Branch: Date:________________________________

Choice of Test Centre

Select centre where you will take NTS test (Tick (one of the following): Islamabad Peshawar Quetta Karachi

(Please note: Request for change of center will not be entertained once choice is exercised. In case candidate does not tick the choice of center for NTS test he/she will be placed as per his /her domicile.)

Admission Intension
I intend to get admission in 4-years undergraduate program in the discipline given below in order of preference:

i) iii)

________________ ________________

ii) iv)

____________________ ____________________

(Please note: It is not necessary to recommend the candidate for admission as per his/her choice. It depends on the availability of seats in the Institutions/ Universities and candidates merit. However HEC will facilitate the students for admission

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but the final responsibility to secure admission at any Public Sector University / Degree awarding Institute lies at the candidate themselves)

Personal Details
Full Name:
(As given in Matriculation / S.S.Certificate)

Fathers Name: Guardian Name:

(In case of death of father)

Relationship with Guardian: Applicants CNIC / Form-B No: (Attach Attested Photocopy of CNIC or Form B)

Fathers / Guardians CNIC No: ________________________ (Attach Attested Photocopy) Date of Birth: Day Age as on (13-08-2010) Day Month Year
(Please note: Age should be less than or equal to 22 years at the time of closing date of receipt of application i.e. 13-08-2010)

Gender: Month Year

Male

Female

Address
i) Postal Address (Where you want to receive letters from HEC): ____________________________________________________________________________________________ _____________________________________________ City__________________________________________

District/Agency/FR______________________________ Province _______________________________________

(Please note: Postal address should be of major city for timely receipt of letters from HEC)

ii) Permanent Address (if different from the above postal address): ____________________________________________________________________________________________ _________________________________________________________ City_______________________________ District/Agency/FR_________________________________ Province: ___________________________________ Phone No: (Compulsory)

i) ii) iii) iv)

Residence (with city code):______________________________ Mobile Number: _________________________________

Fathers/ Guardian Office Number (with city code): _________________ Mobile No: ______________ Any other contact Number (with city code): _____________________ E-mail Address: (Compulsory)

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Email: _________________________________________________________
(Note: If you dont have any email account create it as most of the future correspondence will be done using E-mail address. Do not change your E-mail address and frequently check your mails.)

Domicile: Candidates Domicile (Tick (one of the following and attach attested photocopy) i.
FATA: 1 6 11 Name of Agency/FR ________________________ Bajaur Khyber 3 Kurram 2 North South 8 FR 7 Waziristan Waziristan Peshawar FR Lakki 12 FR D.I. Khan 13 FR Tank 4 9 Mohmand FR Kohat 5 10 Orakzai FR Bannu

ii. Balochistan: Name of District ___________________________ 1 Kalat 2 Mastung 3 Khuzdar 6 Kharan 7 Lasbela 8 Ketch 11 Naseerabad 12 Jaffarabad 13 Jhal Magsi 16 Pishin 17 Loralai 18 Chagi/Dalbadin 21 Harnai 22 Ziarat 23 Kohlu 26 Dera Bugti 27 Killa 28 Musa Khail Abdullah Fathers Domicile: (Tick (one of the following and attach attested photocopy) i) ii) FATA Balochistan

4 9 14 19 24 29

Awaran Gawadar Bolan Nushki Sherani Barkhan

5 10 15 20 25 30

Washuk Panjgur Quetta Sibi Zhob Killa Saifullah

Name of Agency/FR ________________________ Name of District ___________________________

To Be Filled by Already Enrolled Students in Public Sector Universities/Institutions Only

Name of Institution /University____________________________________________________________________ Program Name ______________________________ Duration of Program________________________________ Date of Enrollment____________________________ Total Semester/Years Attended_______________________ Current Semester/Year of Study_________________ Subject__________________________________________
(Note: Please attach copy of Reference Letter of your Institution showing that you are a full time student)

Educational Details
Educational Level SSC / Matric OR *O-level FA/FSc OR *A-level * O-level and A- level applicants will have to provide equivalence of grades/percentages and attestation from IBCC (Inter Board Committee of Chairmen) without which applications will not be processed.
** The candidate whose 12th Class result is awaited may give the detail of 11th Class result with at least 60% marks and hope certificate from Head of Institute/College.

Name of Certificate
(Give Exact Title, as written in the testimonial)

Year of Passing

Marks obtained
(as mentioned in your final year Marks Sheet )

Total Marks

Name of Institution / School

Name of Board / University

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Place of Study: The candidates who have studied in the Institutions located in the districts of Balochistan or Agency or FRs in FATA fall under the category BALOCHISTAN IN and FATA IN category. Those who have studied in the Institutions outside Balochistan and FATA/FRs fall under BALOCHISTAN OUT and FATA OUT category. Please tick the relevant box.

Degree
SSC HSSC

Balochistan In

Balochistan Out

FATA In

FATA Out

Undertaking given by Father/Guardian:

I solemnly verify that the particulars stated above are correct to the best of my knowledge and belief. In case any discrepancy is identified by HEC at any stage, the scholarship of my Son/daughter/ward can be immediately terminated and I will have no right of appeal or seek relief from court of law. Consequently I'll be liable to pay back the entire amount, released by HEC under various expenditure heads, against the scholarship. Name: ___________________________________

CNIC Number: ___________________________________ Signature: Date: ___________________________________ ___________________________________

Please check the list of documents attached with the application form:
Two passport size recent photographs (Attested at the back) An amount of Rs. 500/- as application processing and test fee (non refundable) may be deposited in the HEC Online A/C No. 17427900133401 in Habib Bank Limited, Shalimar Recording Company Branch, H-9, Islamabad. Send us original bank receipt. (Photocopy of the bank receipt or any other form of payment is not acceptable)

Please attach the attested photocopies of followings: SSC/O-level certificate & marks certificate. (Equivalence from IBCC in case of O-level candidate)

HSSC / A-level certificate & marks certificate. (Equivalence from IBCC in case of A-level candidate) Applicants Computerized CNIC or B- Form Applicants Domicile Certificate

Fathers or Guardians Computerized CNIC Fathers or Guardians Domicile Certificate

Signature of the Candidate: __________________________ Related Information

The Application forms completed in all respect along with all the required documents should be reach by the registered post or courier service till 13th August 2010 during office hours (till 4:00 pm). The tentative date for NTS test is 28th August 2010. Roll No. slips will be available online only and applicants are advised to download their roll No. slips from HEC and NTS website (www.hec.gov.pk/balochistan-fata and www.nts.org.pk) after 20th August 2010.

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Prefernce will be given to already enrolled students in 4 to 5 year Undergraduate program in Public Sector Universities/ Institutions. The candidates who are in process of taking admission are advised to provide copy of admission letter/ or any documentry proof maximum by 30th August 2010.

Send the complete filled application form to:

Project Director Balochistan & FATA Scholarship Program Higher Education Commission H-9, Islamabad Tel: 051-90808057 & 051-90808122

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