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National ICT Scholarship Program 2011 School/College Registration Form

6 Floor, HBL Tower Jinnah Avenue, Islamabad Tel: (051) 921 5360 65 Fax: (051) 921 5366

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Name of School/College: Board Affiliation: Postal Address: City/Town: District: Telephone # : Principals Name: Alternate Contact Person: Email Address: Tehsil: Province: Fax # : Mobile # : Mobile # :

Number of students currently studying in your School/College in the following disciplines: Pre Engineering (Maths, Chemistry, Physics) ICS (Maths, Computer, Physics) General Science (with Maths & Physics)

____________________________ Principals Signature

For Office Use Only: Code issued: Issued by:

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