APPLICATION FORM FOR THE AWARD OF INLAND (Political Agent ) SCHOLARSHIP FOR ex-FATA STUDENTS 1. Name of student. Father Name. Domicile. Permanent Home address. PeN 5. Year RNO. Marks Obtained in the last. examination 6. Name of Board/University where last examination passed from 7. Class joined this year. 8 Name of Institution in the present class. 9. Date of Admission in the present class, 10. Father Profession = 11, Whether the applicant is recipient of any other Scholarship. 12. Where the applicant has got admission on the basis of: i. FATA Domicile. ii, On basis of Local Distt Domicile. 13. I solemnly declare that the above entries from S. No 1 to 12 are correct. Signature of applicant___ Class. Roll No. REPORT BY THE PRINCIPAL / HOD Certified that the above named student is regular studentsof ______ “class. No. and he has got admission on the basis of. Domicile Signature of the Principal / HOD With stamp Note: 1. Attested Photo state of Domicile Certificate and DMC must be attached with application form. 2. Scholarship form should be signed by the principal or by the authorized officer and sent with consolidated list under proper covering latter.