[University Name]

Performa for Laptop Distribution Scheme

Name
Fathers Name
CNIC #(Attach the Copy of
CNIC)
Tick Appropriate (Male /
Female)

Contact #
Email
Program / Class of Last
Exam
Details of Last Exam:
Total Marks

Obtained Marks

Exam System (Annual / Semester)

_ Roll No

Percentage
_ Reg No

(Attach Copy of Result Card)

Present Program / Class

Department
Session:
Morning / Evening
Roll No
Documents to be attached:
1. Copy of student ID card or Fee Voucher
2. Copy of CNIC
3. Copy of Result Card (Previous Degree)
I declare that the above mentioned details are true and I have NOTReceived the
Award of Laptopbefore.

Signature
of the
Student

Signature of HOD

In case of providing wrong information, University will take strict action against the
student