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9/5/2016 Student Enrolment Print

ALLAMA IQBAL OPEN UNIVERSITY Form No 134779


ADMISSION FORM FOR OFFICE USE ONLY
Batch NO
NAME OF PROGRAM: M.ED (M.ED (1 YEAR) STE ) DOMICILE DISTT

SEMESTER: AUTUMN 2016

1 Registration No. (If you are Registered with AIOU) 14PSA05254

PERSONAL INFORMATION

3. Name: Mr. ROHAN KHURSHEED

4. Father Name: S/O KHURSHEED AHMAD

Mailing / Postal

5 HOUSE NO. 768 BLOCK D, OLD SATELLITE TOWN

Mailing District: SARGODHA ( 029 ) Mailing Tehsil: SARGODHA(00)


Permament
HOUSE NO. 768 BLOCK D, OLD SATELLITE TOWN
6

Address:
Address:

Permament District: SARGODHA (029 ) Permament Tehsil: SARGODHA ( 00 )

7. Date of Birth: 2-1-1991 8. Mobile No: 03167706006

9. CNIC No/ B Form No : 3840330730023

10. Occupation: STUDENT 11. Qualification: Bachelors

12. Religion: ISLAM 13. Domicile: SARGODHA (029 )


For Account Use

1 0837 EDUCATIONAL RESEARCH

3 0840 EDUCATIONAL PSYCHOLOGY

4 0831 FOUNDATIONS OF EDUCATION

Name of Bank and 14. FOR OFFICIAL USE ONLY


Branch
DISTT TEH EDU LV CLUS ST BANK CODE FT FEE

Bank Challan No. Eligibility

15.
Codi ng
BANK CHALLAN No.

Amount Rs.

http://online.aiou.edu.pk/print.asp?FormNumber=134779 1/3
Dated
9/5/2016 Student Enrolment Print
134779

=12340/- ( twelve thousand three hundred forty

only ) Student Signature

5-9-2016

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9/5/2016 Student Enrolment Print

16. Academic Information

17. Professional Experience (If any)

18. Instructions / Regulation Regarding ADMISSION


1. Admission will not be granted if the admission form is incomplete in any respect (e.g. less fee, unattested photocopies of certificates, partial information).

2. Admission will not be granted if the form or fee is deposited other than procedure mentioned in the prospectus.

3. Photocopy of the addmission form is not acceptable.

4. Candidates are advised to write their address clear and legible handwriting. University reserves the right not to grant admission in case of postal address given
with P.O.Box number or in the case of someone other than candidate's name.

5. Paste one picture on the addmission form.Do not staple

6. During filling form, please write course code very carefully because the admission is made according to course code mentioned by student.

If the student leave the course codes his/her admission will be finalized as per title of courses. In case of any fault / discrepency the student will have to deposit change of
course fee before the due date of first assigment. In case of failing to do so student himself will be responsible for it.

19. AFFIDAVIT
I ROHAN KHURSHEED S/O KHURSHEED AHMAD solemnly agree that:

1. Information given in admission form for Spring / Autumn semesters are true to my knowledge. I have studied / read all the rules and conditions throughly before
filling in admission form.

2. I will abide by the university rules constituted from time to time.

3. In case of litigation , I will file my appeal in the courts of Rawalpindi and Islamabad only.

4. My admission is provisional and the university reserves the right to cancel my admission and confiscate my dues if information given by me is worng.

5. In case of admission in two programes at a time, the university is authorize to cancel admission of the fresh programe and confiscate fee as per rules.

6. I have filled in the admission form with the consent of my parents / guardian.

7. I give my consent to AIOU to use my Mobile No. for necessary communication between AIOU and myself.

8. I also declear that in case of provision of any wrong statment / information at the time of getting admission/ deviation from AIOU prescribed rules / policy in the
advertisement / Prospectus and submission of fake degree or third division on my part (student), the university has the right to cancel my admission and stop my degree.

Permanent Address: HOUSE NO. 768 BLOCK D, OLD SATELLITE TOWN, Tehsil SARGODHA , Distric SARGODHA

Mobile No: 03167706006 E-mail: rohan.khursheed@gmail.com

Dated: 5-9-2016

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9/5/2016 Student Enrolment Print
Signature of Applicant
ALLAMA IQBAL OPEN UNIVERSITY

Bank Branch Code: Bank Officer Signature

ALLAMA IQBAL OPEN UNIVERSITY


Copy No 2.( For Account Department)
Challan No: 134779 Date: 5-9-2016

Bank Branch Code: Bank Officer Signature

ALLAMA IQBAL OPEN UNIVERSITY


Copy No 3. ( For Bank Branch)
Challan No: 134779 Date: 5-9-2016

Bank Branch Code: Bank Officer Signature

ALLAMA IQBAL OPEN UNIVERSITY


Copy No 4. ( For Student)

Challan No: 134779 Date: 5-9-2016

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