Instructions: 1 – Fill in the form completely and do not leave any column blank.

If any column is not applicable to your case, specifically ‘Nil’. 2 – Attestations and other documents are not required at this stage; simply fill-in the form and submit via email. 3 – Any false statement or incomplete information will make you ineligible.

Guidelines: 1 – Personal Details: Your name must match with the exact name printed on your CNIC. Make sure that your CNIC number is absolutely correct. We’ll prefer to have your personal mobile number listed here.

2 – Course Details State the exact title of your programme like MBBS, BE Electrical, BS Information systems etc. Course beginning and completion dates mean the time period starting from your enrollment in university / college to your expected graduation. Let us know very clearly which semester or year you are currently enrolled in.

3 – Academic Records Examination Level means different stages of your programme like 3rd semester, 2nd Prof or 1st year etc.

List all semester / yearly / professional examinations that have been held since your enrollment and whether you have pas those or not.

then provide deta his farm / business in the relevant section of Household Details. If your guardian’s income can be broken down into fixed salary and other income. 6 – Household Details Family members include father. then you must state these other sources in the space provided here. As for the educational fee of the institutes previously attended. Whether employed or retired. You must state the yearly figures for all salaries. then you must state its amount in the relevant column. quote the sum of yearly tuition fee and hostel charges (inca you were living in a hostel). . mother. 4 – Guardian Details You are required to provide specific details of your guardian’s occupation. then say ‘Not declared yet’ in the results status column. you should state h exact designation and organization. earnings and fee. such as rental income from property etc. if he is farmer or shopkeeper. If your guardian is engaged in a commercial activity or self-employed. 5 – Educational Expenditure If you possess sources of financing other than guardian’s monthly salary / income. brothers and sisters.If the result has not been declared for your recent exam. Do not provide vague statements like ‘Government servant’.g. e. Make sure to state your guardian’s yearly income from all sources. Say ‘Nil’ for columns that do not apply.

com Present Address: chiltan super store almas chawk airport road Quetta Permanent Address: H\N# C-57 Power Complex Colony Barotha.Attock Applicant's Status: Orphan Disabled Poor & Deserving Orphan's Only: Mention year of father's death: Disabled Only: Indicate nature of disability: COURSE DETAILS Name of University / College: Title of Programme / Course: Roll No: 9721 fall 2009 Balochistan University of IT Engineering & Management Science BS Textile 3rd Registration No: will complete on: Years: 4 2012 /10/2013 Semesters: 8 3rd Reserved Seats Self Finance Programme started on: Total Duration of your Programme / Course: Currently Enrolled in Year / Semester: Mode of Admission: Open Merit Key person to be contacted in your department: Name: Designation: Zameer ahmad abro Lecturer Tel: 0333-7311944 . Hasan Street. Defence Road. New Lalazar.DIYA PAKISTAN REGISTERED 1304/ APPLICANT'S DETAILS Muhmmad Imad yasir CNIC No: 16202-0604022-3 Mukhtiar muhammad Male Female Age: 20 Father's Name: Gender: Email: Domicile: Swabi Tel: 0300-5511753 muhammadimadyasir@yahoo. Rawalpindi Tel: 051-5859582. Mobile: 0300-5322592 (Office Telephone Timings: 3:00pm to 5:00pm) This Form must be submitted via email to apply@diyapak.

00 Position B C Yes Yes No No Examination Level Month / Year when exam Results Declaration Date Average Percentage or (Mention Year. Prof or was conducted / Status GPA obtained Semester) 2009 2010 2011 OCT april March(2010) september 3.6 3.00 57. Year 2007 2009 2008 Roll No.6 GUARDIAN DETAILS Name: CNIC No: Mukhtiar muhammad 15305-5195265-1 Relationship with Applicant: Father Yearly Income: 150000 Organization: Guardian's Occupation: Accountant Exact Designation: Telephone: 0301-5424956 Accountant Address: . 714637 540723 Marks Obtained 557 629 Total Marks 850 1100 % 67.ACADEMIC RECORD Examination Matriculation Intermediate Bachelors Are you Hafiz-e-Quran? Do you retain Hifz? Current Academic Performance Provide complete details of all examinations that have been administered by your university / college so far. including examinations for which the result has not been declared yet.

then please provide the details of this scholarship: Name of the Donor / Organization: Type of Scholarship: One-time Yearly Monthly If you have stated any amount for 'Income from other sources'. then provide complete details of all such sources: nil Tuition Fee of Institutes Previously Attended Matriculation Name of the Institute Location Yearly Fee Amount of any Scholarship / Remission Availed Wapda Boys High School Attock 4000 Intermediate G D C Attock Attock 10000 .H\N# C-57 Power Complex Colony Barotha.Attock EDUCATIONAL EXPENDITURE Current Expenses on Education Yearly Tuition Fee 23000 Yearly Hostel Fee 10000 Yearly Messing Expenses 40000 Total Expenditure 73000 Sources of Educational Financing other than Guardian's Monthly Income Loan from Relatives / Friends Loan from some organization Scholarship from another organization Remission from College / University Income from other sources Nil nil Nil nil nil If you are receiving scholarship from another organization.

250 Details of family members currently employed / retired Name Nil Age Exact Designation Employer Yearly Salary Details of family members currently engaged in business / commercial activity Name Nil Age Type of Business Location of Business Yearly Earnings Details of family members currently studying Name Fozia Nazia M. for Intermediate you should state the yearly expenses of class XIIth only. brothers and sisters.Arsal khan Age 15 11 9 Institute G G H S Attock G G H S Attock G P S Attock Yearly Fee 1500 1000 730 . Similarly. HOUSEHOLD DETAILS Family Accommodation Details: Note: Family includes father. / Organization Family Owned If rented.Note: For matriculation you should state the yearly expenses you had to incur in class Xth only. mother. Type: Status: House Rented Flat Quarter Mud House Provided by Govt. annual rent: Average monthly electricty bills during the months April to Sept.

servant and our family expenditure is not fulfill by less pay. I want to continue my study but it is possible when you support me plz Kindly support me for making my future.Any other thing that you would like to add or say (related to this application): father is brother and sisters also studying and he cannot afford my educational expenditure. Declaration by the Applicant and his/her Guardian: We.Thanks……………. Signature Stamp / Seal Note: Competent authority includes Area Magistrate. the undersigned solemnly affirm that the details/information provided are accurate and that we shall be responsible for any inaccurate or false information. Tehsildar. Mukhtiarkar or Area Nazim . Naib Tehsildar. Applicant's Signature Guardian's Signature Verification by Tehsildar or Competent Authority: I attest that the information contained in application form is accurate and the applicant deserves the grant of scholarship award.I am the position holder of my class.


For Diya's Office Use Only Decision Reason (if required) History Previous Folio Last Disbursement .

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