Two

photographs

THE RHODES SCHOLARSHIP 2012

APPLICATION FORM FOR PAKISTAN
I wish to apply for a Rhodes Scholarship from Pakistan to commence studies in
October 2012.
Name.
Address.
Phone number Date of birth.
Citizen of Pakistan.. YES / NO (please delete as appropriate)
My age as at 1 October 2012 will be ..years .months.days
Note: candidate must have passed his/her 19th birthday and not have passed his/her 25th birthday
on 1 October 2012.
Name of Schools, Colleges, University attended

Period at each

I passed the following examinations and obtained the results shown (please begin with the
Matriculation or O Level examination)
Examination

Year

Class / Grade /
Division (percentage)

Distinction or
position, if any

Brief details of extra-curricular activities and Honours/Distinctions obtained:

1. Academic

2. Sports

....................................................................................................................................................

3. Any other like debating, cultural or social services etc

Accompanying this application are:

1. A birth certificate (photocopy is satisfactory)
2. Details of academic record, certified by the Headmaster or Registrar of the University, or
other responsible official
3. A statement in my handwriting and signed by me, not exceeding 1000 words, as to my
general interests and activities, the course of study which I propose to follow at the
University of Oxford, and the character of work I intend to pursue.
4. Two un-mounted passport size photographs
5. Names of four referees, along with their addresses. At least three are persons under whom I
have studied
Referee Name

Relationship to referee e.g.

teacher

Referee address

Date.Signature..
The application must reach the Secretary of the Rhodes Trust Scholarship Selection
Committee for Pakistan, P.O. Box No 2939, Islamabad no later than 31 August 2011.