UNIVERSITY OF THE PUNJAB

ADMISSION FORM (Fall - 2019)

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Admission Program: BS Applied Psychology (Morning)
Institute of Applied Psychology
Quaid-i-Azam Campus
Form No.: 1900076641 (12/09/2019 12:54 PM) Received/Verified By: _________________
OPEN MERIT
PERSONAL RECORD
Name: Muhammad Mudassir Khan CNIC: 34602-7561548-3
Father Name: Muhammad Iqbal Khan Father CNIC: 34602-0743301-9
Occupation: Bussiness Man F. Income: 35000
(Father/Guardian) (per month)

Guardian Contact: 03008746959 D.o.B: 22/06/2000

Hafiz-e-Quran: No Religion: Islam
Marital Status: Single Gender: Male
Contact No.: 03454451199 Blood Grp: A-ve
Email: muzi.hussain786@gmail.com Nationality: Pakistani
Province: Punjab District: Sialkot
Permanent Address: Mianwali Bangla P/o Satrah , Tehsil Daska , Distt Sialkot
Postal Address: Mianwali Bangla P/o Satrah , Tehsil Daska , Distt Sialkot
DECLARATION AND SIGNATURE
I, solemnly declare that:
I have neither joined nor shall join any other Institute/Department /Centre/College/School during the course of my studies at University of
the Punjab.
I am not in service /am in service (score out which does not apply). (If in service, a letter of permission from the employer is enclosed)
I am not suffering from any infectious disease.
I understand that the University may vary or reverse any decision made on the basis of incorrect or incomplete information which i have
provided.
I have not yet attained the age of 24 years (for Graduate Level) & 26 years (for Masters Level) programs.
I have read and understood the University's cancellation and refund policy.
I understand that the University may obtain official record from any educational institution I have previously attended.
The entries made in this form are correct.

I, undertake to:
1. Abide by the Statutes, regulations (including the Code of Honour of Students, of University Calendar 1990 Vol. 1) and rules etc. framed by
the University of the Department/Institute/Centre/College/School from time to time and shall be liable to any penalty including
rustication/expulsion, incase of violation on my part.
2. I accept as a condition of my admission the authority of the University that a student can be required to withdraw his name from the rolls, if
in the opinion of the Vice-Chancellor/Director/Chairman/Principal of the Department/Centre/College, his stay is not conducive to the
welfare, either of himself or others in the Department/Institute/Centre/College/School. If the undersigned (student) fail to withdraw my name
immediately after being called upon to do so, it may be struck off the rolls of the Department/Institute/Centre/College/School without any
further notice to me.
3. I am joining this class with the express consent of my father / guardian, who agrees to be responsible for my good conduct and has
appended his signature below in token thereof.
4. Not to "indulge in politics", and in case, I violate this undertaking an "indulge in politics" after my admission by the University, I shall be
liable of expulsion without any notice under the order of the Vice-Chancellor which order shall be final and can be questioned only before
the Supreme Court of Pakistan vide judgment/order of the Supreme Court of Pakistan dated 01 July 1992.
5. I accept as binding on me as long as i am a student, all rules and regulations in force at the time of joining an which might be framed
subsequently.
6. Show good behaiour.
7. Devote whole-heartedly to my studies and maintain the dignity and prestige of the University both in and outside the Campuses.
8. Pay in time all dues and fine, if any.
9. I will notify the new address to Admission Committee (in-case of Graduate & Master level degree program) & Assistant Registrar, DPCC (in-
case of MS/M.Phil & Ph.D level degree program), if there is any change in my contact address/phone number.
10. I undertake to take examination unconditionally notified by the Department/Institute/Centre/College/School.
11. Errors and Omissions excepted (E&OE) and University of the Punjab is not liable to respond any legal or court proceedings.
12. I have read the relevant rules and regulations concerning admission before signing this application.

(Signature of Father/Guardian) (Signature of the Applicant) (Date)

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 ACADEMIC RECORD
Degree Level: Matriculation Roll# 877911 Reg.# 14838410110
Degree Title: Matric Year Annual - 2016
Board/Uni.: BISE Gujranwala Marks 957/1100
Subjects: Mtah , physics , chemistry , biology Grade A+ Div. First
Degree Level: Intermediate Roll# 101423 Reg.# 2-2-1006458-16
Degree Title: F.Sc Pre-Medical Year Annual - 2019
Board/Uni.: BISE Gujranwala Marks 628/1100
Subjects: Biology , Physics , chemistry Grade C Div. Second

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 CHECK LIST
Have You:
Enclosed a letter of permission from the employer (for employees only).
Enclosed a certificate of experience from the employer (for employees only).
Enclosed copies of your all academic transcripts for all Parts separately (including certified translation if
necessary).
Enclosed migration certificate (if graduated from a University other than the University of the Punjab.
Enclosed a certificate of good moral character (Not Applicable for B.Sc. Engineering Admissions).
Enclosed copy of the National Identity Card / Domicile Certificate.
Enclosed copy of the National Identity Card of Applicant's Father/Guardian.
Enclosed copy of the Certificate of Hafiz-e-Quran / Disability / Equivalence / Reserved Quota / Other (if applicable).
Enclosed an Entry Test result slip (if applicable).
Enclosed original deposited fee challan of respective program application.
Note:
All relevant documents be attached by the candidate with his/her application form (entered in form).
No benefit would be given for any document not attached at the time of submitting application or produced
after the closing date of admission.
Applicants shall submit their original documents at the time of admission.

FOR OFFICE USE ONLY

Evaluation Record Admission Status
Matric Admitted: Yes No
F.A/F.Sc
B.A/B.Sc
M.A/M.Sc/LL.B
(Pharm-D or 16/17 Year Education)

MS/M.Phil
(18 Year Education) Director/Chairman/Chairperson/Principal
Teaching/Research Exp.
Written Test
Interview
Total Merit
Remarks: Chairman/Chairperson DPCC/Admission Committee

Cut the postal address written below the line and paste on your Courier Envelope

POSTAL ADDRESS FOR ADMISSION FORM

ADMISSION OFFICE (Graduate),
Program: BS Applied Psychology (Morning),
Institute of Applied Psychology,
Quaid-i-Azam Campus,
University of the Punjab,
Lahore.

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