Akhuwat Educational Assistance Program

Application form for Interest Free Educational Loan

ID : ____________ Date: ____________
(for office use only)

1 photograph INSTRUCTIONS: Please follow the instructions carefully
      Fill in the form using a Black Pen. Fill the form in CAPITAL LETTERS. Please write your name & date of birth in the back of each picture. Fill the form completely; INCOMPLETE forms will not be processed. Attach all the required documents, forms without the Required Documents will be considered INCOMPLETE. YOU SHOULD HAVE AT LEAST 75 % MARKS BOTH IN MATRICULATION & INTERMEDIATE IN ORDER TO APPLY TO AEAP. Moreover, AEAP is a NEED BASED INTEREST FREE LOAN. Thus only those students who genuinely financially deserve will be considered for this Program.

Dispatched: Received:
(for office use only)

________________ ________________

Paste here with glue

CHECKLIST OF THE REQUIRED DOCUMENTS: Please attach the attested copies of the following documents & return it to the address printed in the box below.
□ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ Three passport size photographs Applicant CNIC University/Institution Identity Card Hostel Card Father/Guardian CNIC Bonafide Student Certificate from current University/Institution Level/ SSC (Matriculation) Certificate (issued by BISE) A Level/ HSSC Certificate (issued by BISE) Latest Examination Result Cards Domicile Income Certificate (Pension Copy incase Father/Guardian is Retired Servant) Utility Bill (latest) Distinction/achievement Certificates in Extra & Co curricular Activities _________________________________ Mr. Waseem Asghar _________________________________ _________________________________ 9-A, Upper Mall Scheme

2 Photographs Staple here

Lahore

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1.2 1.4

APPLICANT INFORMATION

(Please use BLOCK LETTERS to fill the form)

1.1 Name:

CNIC Father’s Name 1.6 Relationship with Guardian Present Address (for mailing)
1.8

Date of Birth (dd/mm/yyyy) Guardian’s Name 1.7 Father’s/Guardian CNIC
1.3 1.5

City: Permanent Address
1.9

District:

Province:

City:
1.10 1.12

District:
1.11

Province:

Personal Ph. #:

Home Ph. No’(s):

E-mail: (valid E-mail address is required):

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Program
2.1 SSC

ACADEMIC RECORD
School/College (with city name)

(see list on page 1 for required documents)

Board (e.g.FBISE,Isl)

Passing year

Tot. marks

Obt. marks

% (e.g.80.80)

2.2 HSSC 2.3 ________ 2.4 ________

3
3.1

CURRENT EDUCATION INSTITUTION
Name: Province: Phone #:

(see list on page 1 for required documents)

3.2 City: 3.2 Discipline/Program: 3.4 Duration: __________ years 3.5 No. 3.6

Website:
3.3 Reg.

#: Remaining Semester/year(s)

Started on _________________ dd mm yyyy
_________

Will end on _____________________ dd mm yyyy
___________ ________

of (semester/year)s complete

Current semester/year

Your current grade in latest Result:

______________

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4.1

OTHER SCHOLARSHIP(s)
Are you getting fee concession from Institution? Yes No

(providing true information will favor the applicant) (PKR=Pakistan Rupee) If yes, please mention the % or amount of concession. If yes, please provide following info. Name of Scholarship/organization: _____________________ Amount of Scholarship/loan: ________ PKR

4.2

Are you receiving or applied for Scholarship/loan to another organization? Yes No

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5.1 5.2 5.3 5.4 5.5 5.6

EDUCATION EXPENSES (PKR or ___) (please attach attested copy of fee card or fee deposit slip of last payment)

College/Univ. fee: _________ Monthly Quarterly Semester-wise Annual-wise Books expense: _________ Monthly Quarterly Semester-wise Annual-wise Stationary expense: _________ Monthly Quarterly Semester-wise Annual-wise Hostel fee*: _________ Monthly Quarterly Semester-wise Annual-wise Mess (average)*: _________ Monthly Quarterly Semester-wise Annual-wise Other ( ): _________ Monthly Quarterly Semester-wise Annual-wise Monthly Quarterly Semester-wise Annual-wise 5.7 Total Education expense: _________ *only if you’re residing in College/University hostel & this fee is not included in Para 5.1). Attach attested copy of Hostel Card.

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6.1 6.2

SUPPORT FOR EDUCATION EXPENSES

(PKR or ____)
How much? __________ □ Monthly □Quarterly □ Semester □ Annual Contributing since: _________________ (mm yyyy)

Contribution from your family: __________ Contribution from other(s), (person, relative, scholarship, loan) Name:_______________________________________________________ Other(s): ____________________________________________________
6.3 6.4

Do you teach Tuition(s): Total: __________

Yes

No

If yes, how much do you earn monthly: __________ Monthly Quarterly Semester-wise Annual-wise

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7.1 7.3 7.5 5.4

YOUR REQUEST FOR INTEREST FREE LOAN (PKR or _____)
College/Univ. fee: Stationary expense: Mess (average): Total Loan need: ____________ ____________ ____________ ____________ Monthly
7.2 7.4 7.5

(Please provide genuine need only. Fill it very carefully. If you feel any difficulty, please feel free to contact us)

Books expense: Hostel fee: Other ( Quarterly ):

_________ _________ _________ Annual-wise Semester-wise

8.

MODE OF REPAYMENT:

8.1 When will be able to repay? 8.2 Duration of repayment*. (in years) * Maximum four years allowed for students who need support for their entire academic period.

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BANK ACCOUNT INFORMATION:

(for transaction of loan installments to be given to the student)

9.1 Title of Account 9.2 Bank Name 9.3 Branch Code 9.4 Account Number

b. INCOME:
Income source Profession Annual Income Father’s Guardian’s/Brother’s & sisters Others

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DOCUMENTAION BY THE INSTITUTION:

It is certified that Mr./Ms _______________________________ S/O D/O __________________________________ is student of _______________________________________ under Registration Number ____________________. And that the above information provided in Para 1,2 and 3 is correct to our best of knowledge and information. Mr. Ms _____________________________’s application for Interest Free Loan is recommended.

HEAD OF INSTITUTION/DEPARTMENT Name and Signature with stamp

(FOR STUDENTS RESIDING IN INSTITUTE’S HOSTEL) The above named student is residing in Room No.__________of _______________. He/ She has been residing in this hostel since_____________.

HOSTEL WARDEN (CONCERNED) Name and Signature with Stamp

____________________

__________________________

Applicant’s Signature Date: _____/_____/_____ dd / mm / yy

Father’s/Guardian’s Signature Date: _____/_____/_____ dd / mm / yy

For enquiries contact us at: Phone: 0321-4916686 E-mail: redglaxy2000@gmail.com

Note: In case of providing false information, candidate will be disqualified and his/her application will not be
considered.

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