Photograph

Application No. (AP No.)

Education details:
DETAILS Matric Nursing School
Name and address
of Institution
Date of Passing
Total Marks Obtained
Name of Applicant S/o, D/o
Date of Birth Place of Birth
Female Male
Age on closing date
Note: Candidates are advised to fill the
application form completely. Please read
carefully the instructions for candidates,
attached with the form. Fill the Form in
BLOCK LETTERS wi t h BLACK PEN.
Pakistan Nursing Council Certificate Expiry Date:
Place of Domicile:
Place of practical experience:
Time period of work experience:
CNIC No. Candidate:
CNIC No. Father / Mother / Guardian:
Inter Science
Dow University of Health Sciences, Karachi
APPLICATION FORM
for ADMISSION at
INSTITUTE OF NURSING (ION)
SESSION 2014
Program (Tick Relevent)
Post RN BSc BSc Nursing
(Generic)
1. Matric Certificate attached............................................... Yes No
2. Matric Mark sheet attached .............................................. Yes No
3. Nursing Diploma (In case of Post RN BSc Program) ................... Yes No
4. Mark Sheets of Nursing School ........................................... Yes No
5. Inter Science Certificate (In case of BSc Nursing) attached ........ Yes No
6. Inter Science Mark sheet (In case of BSc Nursing) attached ....... Yes No
7. Pay order for entrance test .............................................. Yes No
8. Candidates domicile of
9. Candidates PRC of
10. Candidates Permanent address on CNIC NADRA / B Form
11. Fathers domicile of
12. Fathers Parmanent address as on CNIC NADRA
DATE OF SUBMISSION
D M Y
Signature of the Applicant
Permanent address
(as on CNIC)
Signature of father/Guardian
Present address
Email address
of Candidate of Father
Contact Nos. of Candidate of Father any other Relative
Tel. No.
Cell No.
This is to certify that Mr. / Miss Son / daughter of
Mr. was a student of this school having been
admitted into class from till
Name of School
Address of School
Name of Student and Fathers Name
Present Address
Permanent Address
Date of Birth
Last Examination Passed
CERTIFICATE FROM PRINCIPAL OF SCHOOL (LAST ATTENDED)
It is further certified that during his/her period of stay his/her conduct & character was
Place
Date
SIGNATURE OF THE
PRINCIPAL WITH SEAL
(a) Seat No.
(b) Enrolment No
(c) Total Marks obtained / Maximum Marks
(d) Division / Grade obtained Percentage Obtained
CERTIFICATE FROM PRINCIPAL OF NURSING SCHOOL (LAST ATTENDED)
This is to certify that Mr. / Miss Son / daughter of
Mr. was a student of this school having been
admitted into class from till
Name of Nursing School
Address of Nursing School
1) Name of Students and Fathers Name
2) Present address
3) Permanent Address
c. Division / Grade Total Marks Obtained / Maximum Marks
d. No. of attempts in which passed
e. Whether received any warning or punishment during the time when he/she was
student of the college, if so give details
Place
Date
SIGNATURE OF THE PRINCIPAL
WITH SEAL
4) Last examination passed
a. Date of Passing College Registration No.
(i) First Year
(ii) Second Year
(iii) Third Year
It is further certified that during his/her period of stay in this college his/her work,
conduct & character was
Marks Obtained Max Marks
b. Marks
Signature of father
Particulars of Father/Mother/ Guardian
1. Name
2. Occupation 3. Designation
4. Place of work
5. Name of organization
6. Office Address
7. Present Residential Address
8. Permanent Address
9. Email address
10. Office Phone Mobile Phone
11. Res. Phone
12. Any Other Contact Number
13. Annual Income 14. Religion
15. Nationality
16. NADRA NIC No.
NOTE: If father is working abroad. These particulars must
be endorsed by Pakistan embassy / consulate of
the respective country.
17. Domicile District
Date of Issuance
Fill all boxes with your present address
Name:
Present Address
Phone No (Res.):
Phone No (Off.):
Mobile No. :
Email:
Name:
Present Address
Phone No (Res.):
Phone No (Off.):
Mobile No. :
Email:
Name:
Present Address
Phone No (Res.):
Phone No (Off.):
Mobile No. :
Email:
Name:
Present Address
Phone No (Res.):
Phone No (Off.):
Mobile No. :
Email:
4
6
IMPORTANT INSTRUCTIONS FOR CANDIDATES
1. Candidates are advised to read the instructions carefully for admission to the Institute of
Nursing of Dow University of Health Sciences for session 2014, before submitting the
application form.
2. Fill all the columns of application form in BLOCK LETTERS with BLACK PEN.
3. Be sure to tick the appropriate Box in the application form..
4. Photocopies of all required documents must be attested by Govt. officer, grade 18 and above.
5. Photocopy of the application form and incomplete form will be rejected.
6. No form will be accepted in any case after the last date and time of the application form.
7. Each application for admission should be accompanied by Non Refundable Entrance Test
Fee of Rs. 1,500/- (Rupees Fifteen hundred Only) in the form of pay-order or demand draft
in the favour of Dow University of Health Science, (DUHS).
8. Carefully check the Required Documents list mentioned in the prospectus before submitting
the application form.
9. Specimen of undertaking will be given when the candidate is declared eligible for provisional
admission.
10. The application form and required documents completed in all respect should be submitted
to United Bank Limited, Baba-e-Urdu Road, Branch, Karachi.
11. If any eligible candidate has not received the admit card 48 hrs prior to the entrance test, he/she
should contact DUHS help desk, mentioned in the Prospectus.
12. In case, there is any change in the date of Entrance test due to some unavoidable situation, it
will be notified on the website of DUHS www.duhs.edu.pk
13. DO NOT submit the original documents alongwith the application form.
14. All queries should be sent on email address mentioned on the Back page.
15. No candidate should contact personally for any queries.
17. Daily visit the website of DUHS for announcement and informations.
Note: DO NOT attach this page with your application form.
Dow University of Health Sciences, Karachi.
Left Hand Thumb Impressi on
of Candidat e
DUHS Copy
Name:
Fathers Name:
Postal Address:
Tel No: Mobile No: E.mail:
Please Paste
(1 x 1)
Photograph
Roll No.
Signature of
Candi date
ADMIT CARD
ENTRY TEST
Dow University of Health Sciences, Karachi.
Name:
Fathers Name:
Postal Address:
Tel No: Mobi le No: E.mail :
FOR ADMISSIONS
at
Session 2014
Candidates Copy
ADMIT CARD
ENTRY TEST
Please Paste
(1 x 1)
Photograph
Roll No.
Note: See Instructions Overleaf
Name:
Signature
Seal
For Official Use
Left Hand Thumb
Impression of
Candidate
Signature of
Candidate
Date:
Time:
Venue:
Name:
Signature
Seal
For Official Use
Date:
Time:
Venue:
FOR ADMISSIONS
at
Session 2014
1. If there is any change regarding Entry Test, venue or timings, it will be mentioned
on DUHS website.
2. Carefully read instructions for attempting test paper, otherwise computer will not
read your answers.
3. Candidate must bring this Admit Card for the test, on the date, time and venue given
overleaf.
4. CANDIDATE WILL NOT BE ALLOWED TO APPEAR IN THE TEST WITHOUT
THIS ADMIT CARD.
5. No I dentification other than this Admit Card will be acceptable.
6. Impersonation for the Entrance test will be considered as a criminal case and will
be dealt seriously.
7. Candidate is required to reach the venue at least two (02) hours before the test.
8. Any material or electronic device / mobile phone / calculator etc, will not be allowed,
under any circumstances.
9. If any student is found, using unfair means or cheating he will be debarred from the
test and admission.
INSTRUCTION FOR THE CANDIDATE