The Aga Khan University, Pakistan

Application Tracking ID: 00023128

The last date to submit this application form is May 28, 2018.

Instructions

The completed application must include the following:

i. Hard copy of this completed application form;

ii. Two passport size colour photographs bearing your name and attestation on the back. [Photo should show clear full face and must be
taken within the last one week to reflect your current appearance.]

iii. Attested photocopies of mark sheets/official transcripts/general certificates as entered on the form. All documents must be in A4 size;

iv. Attested photocopy of 'B' Form/CNIC/NICOP for candidates applying from Pakistan or relevant pages of passport for overseas
applicants;

v. An extra envelope bearing your name, address and contact number. This envelope will be used to send admit card to you;

vi. Original payment receipt of the application fee.

Candidates applying from AKU residential countries*: Rs. 5,800

Candidates applying from AKU non-residential countries: US$ 300

MODE OF PAYMENT

The original payment receipt should be sent along with the application form to the Admission Office. You must send the original payment
acknowledgement slip. Please do not send the payment request slip.

Please use any of the following options to make payment

1. Bank Draft

The payment can be made by a demand draft/banker's cheque/cashier's cheque/pay order in favour of "The Aga Khan University". This
option is not available for paying foreign currency.

2. Online Funds Transfer to University's Bank Account

Banking Details for Pakistani Currency

Candidates in Pakistan can pay through online deposit to any branch of the Soneri Bank.

Title: The Aga Khan University

Account #: 01021227508
Branch Code: 0024
Branch: The Aga Khan University Branch, Stadium Road, Karachi
NTN #: 1206240-5
IBAN #: PK49SONE0002401021227508

Banking Details for Foreign Currency

Candidates overseas can pay through telex transfer.

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Telex Transfer

Title: The Aga Khan University

Bank: Habib Bank Limited
Branch: Plaza Branch – Branch Code 786
Account #: 0786-79014650-11
Swift Code: HABBPKKA
IBAN #: PK11 HABB 0007 8679 0146 5011

Intermediary Bank

Bank: JP Morgan Chase Bank, New York, USA

Swift Code: CHASUS33
Beneficiary bank: Habib Bank Ltd, Head Office, Treasury, Karachi, Pakistan
Swift Code: HABBPKKAXXX

3.University E-Payment Facility

Candidates can choose to pay fee online through a credit/debit card. Please use this web link to pay: https://payonline.aku.edu/

Please notify the Finance Office through emailing at student.finance@aku.edu when making e-payments. Student name, address,
application tracking ID, amount, payment reference # and the purpose of payment should be clearly stated in the notification. The
acknowledgement email received against e-payment must also be sent with the Application Form.

The completed application must be sent through courier to the Admission Office at the following address:

Office of the Registrar

Medical College – MBBS Programme
Aga Khan University
Stadium Road, Karachi 74800
+9221 3486 4410/4412

For more programme information, payment and other details: www.aku.edu/admissions/mbbs

________________________
*Afghanistan, Burundi, Kenya, Pakistan, Rwanda, Tanzania and Uganda

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 The Aga Khan University, Pakistan
Bachelor of Medicine, Bachelor of Surgery (MBBS) - 2018
Full-Time
Application Tracking ID: 00023128 Application Submission Date: 06/04/2018

Attested 7 days old

Passport size
photograph bearing For Official Use Only
the name of the
applicant at the back
Student ID
(Please do not attest
at candidate face)
Application #
Please staple

Personal Information
First Name Shafiq Gender Male
Middle Name Ur Marital Status Single
Last Name Rahman Father's/Mother's Name Atiq Ur Rahman
Date of Birth 07/06/1999 Country of Current Residence Pakistan
Nationality Pakistan Passport/NICOP Nbr -
National ID 15101-2549745-9 Previous AKU Student ID -
Mobile # 000 346/967-7589 Landline/Alternate # -
Email Address urrahmanshafiq60@gmail.com

Address Details
Current Mailing Address Permanent Address
Address Village: Nanser, P/o Jowar, Tehsil: Daggar Village: Nanser, P/o Jowar, Tehsil: Daggar
District: Buner ,Kpk, Pakistan District: Buner ,Kpk, Pakistan
Country Pakistan Pakistan
City & Postal Code Peshawar 25000 Peshawar 25000
Province/State Pakistan/buner/kpk Pakistan/buner/kpk

Test Centre & Interview Centre Information

Test Centre Peshawar Interview Centre Karachi

Official: Please do not write below

Application Status: Complete Incomplete Provisional System Of Education: ______________
Application Fee: Local Foreign Documents Awaited: ____________________________________
Date:___________ Received By:__________

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Education/Professional Qualification Details
Certificate/ Institution Board/Country Results Year of Total Obtained Division/
Degree/ Awaited Admission - Marks Marks GPA/
Qualification Year of Grade
Completion
Higher Govt Degree BISE, SWAT Yes 2015-2017 - - -
Secondary College Daggar,
Certificate Buner, Buner
Secondary Ibne Zubair Public BISE, SWAT No 2013-2015 1100.00 991.00 -
School School Jowar,
Certificate Buner, Buner

AKU Information
How did you come to know about AKU programmes? Website/Social Media

Terms & Conditions

Aga Khan University reserves the right of admission. The University reserves the right to revoke
admission / registration / enrolment if, in its sole discretion, it establishes that the information provided is
inaccurate, incomplete and / or if it determines that the supporting documents are fraudulent. Any
applicant who presents a fraudulent document in support of an application for admission may be
identified to other universities and colleges.

In submitting this application for admission I declare that the statements I have made in my application
are true. I understand the implications of not providing the equivalence / eligibility certificate if
provisionally selected. I agree to conform to the discipline of the selection process and to accept the
decision of Aga Khan University concerning the evaluation of my application and the final selection.

Applicant's Signature: ________________________ Date: _______________

Parent's/Guardian's Signature: _________________ Date: _______________

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