Registration/Tracking No.

QUAID-I-AZAM UNIVERSITY For BS/Pharm.D/LL.B

ADMISSION DATA SUMMARY SHEET

Form No. PLEASE ENCIRCLE THE PROVINCE CODE

AJK AZAD JAMMU & KASHMIR
Nationality Domicile BLCH BALOCHISTAN
FATA FED. ADMINS. TRIBAL AREA
City Town/Tehsil KPK KHYBER PAKHTUNKHWA PHOTO
PNJB PUNJAB
District State/Province SNDH (R) SINDH (RURAL)
SNDH (U) SINDH (URBAN)
NOTE: ALL THE COLUMNS GIVEN BELOW ARE TO BE FILLED, INCOMPLETE
FORM WILL NOT BE ENTERTAINED
APPLICANT'S NAME (IN BLOCK LETTER)

FATHER'S NAME (IN BLOCK LETTER)

COMPUTERIZED NATIONAL IDENTITY CARD # Please

DATE OF BIRTH SEX BLOOD GROUP Mention Passport No. in case of Foreign National

POSTAL ADDRESS

Tel No: email:

ACADEMIC RECORD
Note: The candidate must encircle the box below certify his Intermediate type
Matric, SSC, O Level etc. with with Equivalence Certificate
Equivalence Certificate
Pre-Medical Pre-Engineering ICS I.Com. A Level Others
Total Marks Marks Obtained Total Marks Marks Obtained

Encircle one of the following, if desired to apply on Reserved Seats

1. Minority 2. Disabled Person 3. Children of Army Personnel

4. Sports 5. Foreigners 6. Any Other
DISCIPLINES/SUBJECTS CODE LIST
Faculty of Natural Sciences Faculty of Biological Sciences Faculty of Social Sciences
CODE DISCIPLINE CODE DISCIPLINE CODE DISCIPLINE
BS COM Computer Science BS BCH Biochemistry BS ARC Archaeology
BS CHM Chemistry BS BIT Biotechnology BS BBA Business Administration
BS ELE Electronics BS BIF Bioinformatics BS ECO Economics
BS GEO Geophysics BS BOT Botany BS HIS History
BS MAT Mathematics BS ENV Environmental Sciences BS IR International Relation
BS IT Information Technology BS MIC Microbiology BS POL Political Science
BS PHY Physics BS ZOO Zoology BH LLB L.L.B
BS STS Statistics BD PHM Pharm-D
DISCIPLINE PRIORITIES

Priority Subject Code Regular/Self Finance Priority Subject Code Regular/Self Finance
1st 4th
2nd 5th
3rd 6th

Signature of the Candidate

 DECLARATION/UNDERTAKING BY THE CANDIDATE

(a) That the information given in the Admission Form is correct to the best of my knowledge, belief and if anything is found
incorrect/misleading or concealment of facts, Quaid-i-Azam University (QAU), shall have the right to refuse/cancel my admission and
expel me from the University/
(b) That I promise to: -
(i) Abide by the Statutes, Rules and Regulations etc. framed by the QAU and any other instructions issued from time to time.
(ii) Maintain good behaviour during studies and while being on Campus.
(iii) Work diligently and maintain dignity and prestige of QAU both ON and OFF the Campus.
(c) That I undertake to be a full-time regular student of the QAU and shall not join any other programme of study or accept any employment
for the duration of the programmes registered. (In-service candidates are required to produce NOC/Study Leave duly sanctioned by the
Employers/Authority).
(d) That I further undertake that I shall not claim hostel accommodation as a matter of right if admitted to the QAU.
(e) That I further undertake that I shall not claim hostel accommodation as and when required by QAU.
(f) That I hereby declare as a binding on me that as long as I am a student I shall abide by all the Statutes, Rules and Regulations, inforce at
the time of joining the QAU and framed subsequently. I shall submit myself to the discipline of the QAU authorities as exercised through
its various Committees and Officers.
(g) That I shall not claim/apply for any financial support/fee waivers/exemption once I am admitted to the QAU on Self Finance basis.
(h) That the requisite documents i.e. Marks Sheets/Certificates etc. as submitted by me are genuine and in case found fake/bogus/ tampered,
the QAU shall have a right to refuse/cancel my admission and expel me from the University OR initiate Legal Action against me.
(I) That I will produce/submit originals of requisite documents i.e. Marks Sheets/Certificates etc. at the time of interview for admission.

Signature of the Candidate

DECLARATION/UNDERTAKING BY FATHER/GUARDIAN (Applicable for Undergraduate Programme):

I am responsible for the behaviour and conduct of my son/daughter/ward, during his/her stay at the QAU and shall fully cooperate with
the QAU Authorities in this regard as/when/how required by the QAU. I am enclosing a signed copy of CNIC as proof of my undertaking.

Signature of the Parent/Guardian

S# Documents No. of copies

1. Detail Marks Certificate of SSC (Matriculation) Examination or equivalent. 01
2. Detail Marks Certificate of HSSC (Intermediate) Examination or equivalent. 01
3. CNIC OR Form B in case of under 18-years of age. 01
4. CNIC of Father/Parents/Guardian. 01
5. Domicile Certificate of candidate OR of father/mother if the applicant is under 18-years of age and his/her name is 01
included in it.
6. Character Certificate from the institution last attended. 01
7. Equivalence Certificate and conversion of the grades, into marks from Inter Board Committee of Chairman (BCC) for 01
Matric and Intermediate levels in case of qualifications OR certificate from foreign institutes
8. Sports Certificates i.e. District/Province/National/International level issued by the concerned Authorities (for applicants 01
of Sports Reserve Seats)
9. Disability Certificate issued by the District Assessment Board (for applicants of Disabled Reserve Seats) 01
10. Minority Certificate issued by the Principal of last attended institute (for applicants of Minority Reserve Seats) 01
11. Army Personal Service Card OR Pension Book of Parent (for applicants of Children of Army Personal) 01
12. Foreign Citizenship OR Passport for Foreign National and Dual Nationals (having Pakistani and some other nationality) 01
Refugees (status recognized by Govt. of Pakistan) (for Foreigner Reserve Seats)
13. Letter of Registration from Pharmacy Council of Pakistan duly verified by the Chairman concerned of the (parents) (For 01
the Children of Registered Pharmacists on Reserve Seats in Pharm-D program only)
14. (i). Proof from Health Department/Drug Regularity Authority of Pakistan duly verified by the Chairman concerned. 01
(ii). Donation in shape of cash/equipment/chemical worth at least Rs.100,000/- (For the Children of Proprietors,
partners and directors of Pharmaceutical industry on Reserve Seats in Pharm-D program only)
15. Original HBP/Askari Bank Deposit Slip of Rs.2500/- (For Admission Form of QAU) 01
16. Any other supporting/relevant document 01
 DECLARATION/UNDERTAKING BY THE CANDIDATE

In response to the advertisement for admission to Undergraduate Program (Fall Semester 2017) I, ____________________________

S/O, D/O__________________________________ intend to get admission in this University. Unfortunately, the following encircled

requisite document (s) is/ are missing while submitting the admission form:

S# Documents
1 Detail Marks Certificate of SSC (Matriculation) Examination or equivalent.
2 Detail Marks Certificate of HSSC (Intermediate) Examination or equivalent.
3 CNIC OR Form B in case of under 18-years of age.
4 CNIC of Father/Parents/Guardian.
Domicile Certificate of candidate OR of father/mother if the applicant is under 18-years of age and
5 his/her name is included in it.
6 Character Certificate from the institution last attended.
Equivalence Certificate and conversion of the grades, into marks from Inter Board Committee of
7 Chairman (BCC) for Matric and Intermediate levels in case of qualifications OR certificate from foreign
institutes
Sports Certificates i.e. District/Province/National/International level issued by the concerned Authorities
8 (for applicants of Sports Reserve Seats)
9 Disability Certificate issued by the District Assessment Board (for applicants of Disabled Reserve Seats)
10 Minority Certificate issued by the Principal of last attended institute (for applicants of Minority Reserve Seats)
11 Army Personal Service Card OR Pension Book of Parent (for applicants of Children of Army Personal)
Foreign Citizenship OR Passport for Foreign National and Dual Nationals (having Pakistani and some other
12 nationality) Refugees (status recognized by Govt. of Pakistan) (for Foreigner Reserve Seats)
Letter of Registration from Pharmacy Council of Pakistan duly verified by the Chairman concerned of the
13 (parents) (For the Children of Registered Pharmacists on Reserve Seats in Pharm-D program only)
(i). Proof from Health Department/Drug Regularity Authority of Pakistan duly verified by the
Chairman concerned. (ii). Donation in shape of cash/equipment/chemical worth at least Rs.100,000/-
14 (For the Children of Proprietors, partners and directors of Pharmaceutical industry on Reserve Seats in
Pharm-D program only)
15 Original HBP/Askari Bank Deposit Slip of Rs.2500/- (For Admission Form of QAU)
16 Any other supporting/relevant document

1. I, undertake to submit the above mentioned missing documents to the Admission Section (QAU) on or before 03-10-2017 during the
office hours positively.
2. I understand that I will be admitted subject to the submission of the above mentioned encircled document (s).
3. I will be considered for admission to Undergraduate Programme only if I fulfill the eligibility criteria and merit.
4. I will not file a civil suit in any court of law or challenge the admission already selected students in case of non-submission of the
requisite documents during the stipulated time period.
5. I will not claim admission as a matter of right without submission of the above mentioned encircled document (s).
6. I understand that University has the right to cancel or refuse my admission without assigning any reason.
7. In case of incorrect/misleading information or concealment of facts, the University will have the right to refuse/cancel the admission and
expel the student from the University.
8. I have paid missing documents late submission processing fee amounting to Rs.1000/- vide HBL/Askari Bank Challan
No._________________ Dated____________2017 (Copy attached).

Dated: _________/2017 Signature_____________________________

Name___________________________________________________

Father's Name____________________________________________

Tracking ID/Registration # of QAU:UF17-______________

 QAU COPY BANK COPY

Quaid-i-Azam University, Islamabad Quaid-i-Azam University, Islamabad

Branch Code Date Branch Code Date
Branch Name Branch Name

ONLINE DEPOSIT SLIP ONLINE DEPOSIT SLIP

ASKARI BANK LTD. ASKARI BANK LTD.

Any Remote Branch of Any Remote Branch of
Askari Bank Ltd Askari Bank Ltd
Account Title QAU Receipt Account No. 150149000008-1 Account Title QAU Receipt Account No. 150149000008-1

Note: No Bank Service Charges Note: No Bank Service Charges

Note: Desired Bank Stamp is required on the Deposit Slip & Send Original Deposit * Note:
Slip (QAU Copy) along Application Form Application to Quaid-i-Azam University, 1. Please Stamp both copies of deposit Slip.
Islamabad. Form will not be entertained without Original Deposit Slip (QAU Copy) 2. The Bank Must Return QAU Copy to the Candidate.
3. Deposit Slip will not accepted without Candidates Required Documents.

Applicants Name Applicants Name

Fathers Name Fathers Name

CNIC/ Form.B. No. CNIC/ Form.B. No.

Prospectus Charges RS: 2,500/- Prospectus Charges RS: 2,500/-

Applicants Sig. Cashier Officer Applicants Sig. Cashier Officer

STUDENTs COPY ACCOUNT COPY

Quaid-i-Azam University, Islamabad Quaid-i-Azam University, Islamabad

Branch Code Date Branch Code Date
Branch Name Branch Name

ONLINE DEPOSIT SLIP ONLINE DEPOSIT SLIP

ASKARI BANK LTD. ASKARI BANK LTD.

Any Remote Branch of Any Remote Branch of
Askari Bank Ltd Askari Bank Ltd
Account Title QAU Receipt Account No. 150149000008-1 Account Title QAU Receipt Account No. 150149000008-1

Note: No Bank Service Charges Note: No Bank Service Charges

Note: Desired Bank Stamp is required on the Deposit Slip & Send Original Deposit * Note:
Slip (QAU Copy) along Application Form Application to Quaid-i-Azam University, 1. Please Stamp both copies of deposit Slip.
Islamabad. Form will not be entertained without Original Deposit Slip (QAU Copy) 2. The Bank Must Return QAU Copy to the Candidate.
3. Deposit Slip will not accepted without Candidates Required Documents.

Applicants Name Applicants Name

Fathers Name Fathers Name

CNIC/ Form.B. No. CNIC/ Form.B. No.

Prospectus Charges RS: 2,500/- Prospectus Charges RS: 2,500/-

Applicants Sig. Cashier Officer Applicants Sig. Cashier Officer

 QAU COPY BANK COPY

Quaid-i-Azam University, Islamabad Quaid-i-Azam University, Islamabad

Branch Code Date Branch Code Date
Branch Name Branch Name

ONLINE DEPOSIT SLIP ONLINE DEPOSIT SLIP

HABIB BANK LTD. HABIB BANK LTD.

Any Remote Branch of Any Remote Branch of
Habib Bank Ltd Habib Bank Ltd
Account Title QAU Fee Dues Account Account No. 0042-79016066-03 Account Title QAU Fee Dues Account Account No. 0042-79016066-03

Note: Rs. 2515/- per Transaction to be Paid by the Depositor Note: Rs. 2515/- per Transaction to be Paid by the Depositor

Note: Desired Bank Stamp is required on the Deposit Slip & Send Original Deposit Slip * Note:
(QAU Copy) along Application Form Application to Quaid-i-Azam University, Islamabad. 1. Please Stamp both copies of deposit Slip.
Form will not be entertained without Original Deposit Slip (QAU Copy) 2. The Bank Must Return QAU Copy to the Candidate.
3. Deposit Slip will not accepted without Candidates Required Documents.

Applicants Name Applicants Name

Fathers Name Fathers Name

CNIC/ Form.B. No. CNIC/ Form.B. No.

Prospectus Charges RS: 2,515/- Prospectus Charges RS: 2,515/-

Applicants Sig. Cashier Officer Applicants Sig. Cashier Officer

STUDENTs COPY ACCOUNT COPY

Quaid-i-Azam University, Islamabad Quaid-i-Azam University, Islamabad

Branch Code Date Branch Code Date
Branch Name Branch Name

ONLINE DEPOSIT SLIP ONLINE DEPOSIT SLIP

HABIB BANK LTD. HABIB BANK LTD.

Any Remote Branch of Any Remote Branch of
Habib Bank Ltd Habib Bank Ltd
Account Title QAU Fee Dues Account Account No. 0042-79016066-03 Account Title QAU Fee Dues Account Account No. 0042-79016066-03

Note: Rs. 2515/- per Transaction to be Paid by the Depositor Note: Rs. 2515/- per Transaction to be Paid by the Depositor

Note: Desired Bank Stamp is required on the Deposit Slip & Send Original Deposit Slip * Note:
(QAU Copy) along Application Form Application to Quaid-i-Azam University, Islamabad. 1. Please Stamp both copies of deposit Slip.
Form will not be entertained without Original Deposit Slip (QAU Copy) 2. The Bank Must Return QAU Copy to the Candidate.
3. Deposit Slip will not accepted without Candidates Required Documents.

Applicants Name Applicants Name

Fathers Name Fathers Name

CNIC/ Form.B. No. CNIC/ Form.B. No.

Prospectus Charges RS: 2,515/- Prospectus Charges RS: 2,515/-

Applicants Sig. Cashier Officer Applicants Sig. Cashier Officer

 QAU COPY BANK COPY

Quaid-i-Azam University, Islamabad Quaid-i-Azam University, Islamabad

Branch Code Date Branch Code Date
Branch Name Branch Name

ONLINE DEPOSIT SLIP ONLINE DEPOSIT SLIP

ASKARI BANK LTD. ASKARI BANK LTD.

Any Remote Branch of Any Remote Branch of
Askari Bank Ltd Askari Bank Ltd
Account Title QAU Receipt Account No. 150149000008-1 Account Title QAU Receipt Account No. 150149000008-1

Note: No Bank Service Charges Note: No Bank Service Charges

Note: Desired Bank Stamp is required on the Deposit Slip & Send Original Deposit * Note:
Slip (QAU Copy) along Application Form Application to Quaid-i-Azam University, 4. Please Stamp both copies of deposit Slip.
Islamabad. Form will not be entertained without Original Deposit Slip (QAU Copy) 5. The Bank Must Return QAU Copy to the Candidate.
6. Deposit Slip will not accepted without Candidates Required Documents.

Applicants Name Applicants Name

Fathers Name Fathers Name

CNIC/ Form.B. No. CNIC/ Form.B. No.

Processing Fee for Left Processing Fee for Left
Over Documents RS: 1,000/- Over Documents RS: 1,000/-

Applicants Sig. Cashier Officer Applicants Sig. Cashier Officer

STUDENTs COPY ACCOUNT COPY

Quaid-i-Azam University, Islamabad Quaid-i-Azam University, Islamabad

Branch Code Date Branch Code Date
Branch Name Branch Name

ONLINE DEPOSIT SLIP ONLINE DEPOSIT SLIP

ASKARI BANK LTD. ASKARI BANK LTD.

Any Remote Branch of Any Remote Branch of
Askari Bank Ltd Askari Bank Ltd
Account Title QAU Receipt Account No. 150149000008-1 Account Title QAU Receipt Account No. 150149000008-1

Note: No Bank Service Charges Note: No Bank Service Charges

Note: Desired Bank Stamp is required on the Deposit Slip & Send Original Deposit * Note:
Slip (QAU Copy) along Application Form Application to Quaid-i-Azam University, 4. Please Stamp both copies of deposit Slip.
Islamabad. Form will not be entertained without Original Deposit Slip (QAU Copy) 5. The Bank Must Return QAU Copy to the Candidate.
6. Deposit Slip will not accepted without Candidates Required Documents.

Applicants Name Applicants Name

Fathers Name Fathers Name

CNIC/ Form.B. No. CNIC/ Form.B. No.

Processing Fee for Left Processing Fee for Left

Over Documents RS: 1,000/- Over Documents RS: 1,000/-

Applicants Sig. Cashier Officer Applicants Sig. Cashier Officer

 QAU COPY BANK COPY

Quaid-i-Azam University, Islamabad Quaid-i-Azam University, Islamabad

Branch Code Date Branch Code Date
Branch Name Branch Name

ONLINE DEPOSIT SLIP ONLINE DEPOSIT SLIP

HABIB BANK LTD. HABIB BANK LTD.

Any Remote Branch of Any Remote Branch of
Habib Bank Ltd Habib Bank Ltd
Account Title QAU Fee Dues Account Account No. 0042-79016066-03 Account Title QAU Fee Dues Account Account No. 0042-79016066-03

Note: Rs. 1,015/-per Transaction to be Paid by the Depositor Note: Rs. 1,015/-per Transaction to be Paid by the Depositor

Note: Desired Bank Stamp is required on the Deposit Slip & Send Original Deposit Slip * Note:
(QAU Copy) along Application Form Application to Quaid-i-Azam University, Islamabad. 4. Please Stamp both copies of deposit Slip.
Form will not be entertained without Original Deposit Slip (QAU Copy) 5. The Bank Must Return QAU Copy to the Candidate.
6. Deposit Slip will not accepted without Candidates Required Documents.

Applicants Name Applicants Name

Fathers Name Fathers Name

CNIC/ Form.B. No. CNIC/ Form.B. No.

Processing Fee for Left Processing Fee for Left
Over Documents RS: 1,015/- Over Documents RS: 1,015/-

Applicants Sig. Cashier Officer Applicants Sig. Cashier Officer

STUDENTs COPY ACCOUNT COPY

Quaid-i-Azam University, Islamabad Quaid-i-Azam University, Islamabad

Branch Code Date Branch Code Date
Branch Name Branch Name

ONLINE DEPOSIT SLIP ONLINE DEPOSIT SLIP

HABIB BANK LTD. HABIB BANK LTD.

Any Remote Branch of Any Remote Branch of
Habib Bank Ltd Habib Bank Ltd
Account Title QAU Fee Dues Account Account No. 0042-79016066-03 Account Title QAU Fee Dues Account Account No. 0042-79016066-03

Note: Rs. 1,015/-per Transaction to be Paid by the Depositor Note: Rs. 1,015/-per Transaction to be Paid by the Depositor

Note: Desired Bank Stamp is required on the Deposit Slip & Send Original Deposit Slip * Note:
(QAU Copy) along Application Form Application to Quaid-i-Azam University, Islamabad. 4. Please Stamp both copies of deposit Slip.
Form will not be entertained without Original Deposit Slip (QAU Copy) 5. The Bank Must Return QAU Copy to the Candidate.
6. Deposit Slip will not accepted without Candidates Required Documents.

Applicants Name Applicants Name

Fathers Name Fathers Name

CNIC/ Form.B. No. CNIC/ Form.B. No.

Processing Fee for Left Processing Fee for Left

Over Documents RS: 1,015/- Over Documents RS: 1,015/-

Applicants Sig. Cashier Officer Applicants Sig. Cashier Officer