Of Science & Information Technology

Program:
MOST IMPORTANT
Please attach attested photocopies of: (a) Academic Certificates: (b) Merit Certificate(s) if any: (c) Character Certificate
from Head of the Institution last attended: (d) Detailed Marks Certificates (e) National I.D. Card (f) Domicile Certificate
(g) Migration Certificate from the last Board/University must be provided within one month after confirmation of admission
(h) Four passport size photographs.

(In block letters):

Student Cell #

Guardian Cell #

Land Line # (with area code)

Land Line # (with area code)

Email:

If ever been enroled in Qurtuba University as a student:

(For In-Service candidates only)

Name of Org. / Dept.

Duration:

Phone No:

(Note: NOC/Study leave signed by the competent authority must be provided within one month after confirmation of admission)
 Degree/
Certificate Specialization /CGPA

Matric

Intermediate

Bachelor

Master

do hereby solemnly undertake to abide

1. I agree and authorize the university to publish my photograph in its documents, web page, magazines etc.
2. The University has the right to make any change in the courses offered and the fee structure at any time during the
tenure of my study.
3. I shall abide by the code of conduct, instructions, academic and disciplinary rules and regulations of the
University.
4. I shall not have any direct/indirect affiliation with any political party during my studies at Qurtuba University and
shall not indulge in any subversive activity.
5. In case i am found guilty of indulging in any political activity, strikes, unionism, or any activity jeopardizing the
sanctity of the University, i may be expelled from the University without any prior notice.
6. I shall deposit all fees and dues as may be prescribed from time to time by the university in time. I also understand
that all fees and dues paid are non-refundable.
7. I will maintain minimum 85% attendance in each subject, failing, which i shall not be entitled to sit in the
examination.
8. To the best of my knowledge, the information contained in this application is correct and complete. All documents
submitted in support of my application are the permanent possession of the University. Further any incorrect
information given by me in this form shall make me liable for disciplinary action including cancellation of my
admission.

9. I, father/ Guardain, of Mr/ Ms.________________________________ do hereby affirm that i shall be fully

responsible for the wholesome conduct of my son/daughter/ward during the tenure of the course of his/her
studies and shall not claim any compensation on behalf of my son/daughter/ward on account of unavoidable
losses and also shall not challenge the removal/rustication of my son/daughter/ward from the University on
account of violation of any clause of the undertaking

(Incharge Admissions)
 Of Science & Information Technology

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 INSTRUCTIONS

1. Attach attested copies of all documents as mentioned in this Form and fill all
particulars and submit it to the admission office or send it on respective Campus address
via any Courier Service.

D. I. Khan Campus
Registrar, Qurtuba University of Science & Information Technology,
Sheikh Yusuf Road, Dera Ismail Khan.

Peshawar Campus
Admission Officer, Qurtuba University of Science & Information Technology,
Sector K-1, Street-4, Phase-3, Hayatabad, Peshawar
2. Incomplete Form will not be entertained and the applicant will not be called for test
and interview.
3. The office will not be held responsible for delay in submission of Form by Courier Service.
4. It is mandatory for all applicants to collect University Prospectus from the University
Admission Office on the date of Entry test to be announced by the University. The
University prospectus contains all necessary rules/regulations and other information
for guidance purpose.