UNIVERSITY OF THE PUNJAB

(REGISTRATION BRANCH)

1 2 7 0 0 0 8 1 5 8
Application Form for Registration of Private Candidate for Associate Degree in
Arts/Science/Commerce Examination 2022
Note: If a candidate is already registered in the University of the Punjab, either as Regular or Private he should not submit the
Registration Form again.

Form No.: 0008158 (15/12/2021 11:53 AM) Received & Checked By:

PERSONAL RECORD (As Per Previous Exam Record)

Name: Ulfat Hussain CNIC: 38401-5985442-3
Father Name: Tariq Mehmood Father CNIC: 38401-3763347-5
Date of Birth: 16/11/2001 Religion: Islam
Contact No.: 03046734797 Gender: Male
Present Address: House Number F/570 Manzoor Hayat Colony Bhalwal, District Sargodha
Permanant Address: House Number F/570 Manzoor Hayat Colony Bhalwal, District Sargodha

ACADEMIC RECORD
Exam. Passed Year Roll No. Registration No. Board / University / IBCC Equ. Cert.
Matriculation A-2018 250364 3840159854423 Bise Sargodha
Intermediate A-2021 419603 3840159854423 Bise Sargodha

FEE RECORD
Bank Branch Challan No. Date Amount
HBL 0589 Shahrah-e-liaquat Bhalwal 817913 15/12/2021 4,500
Total Amount (In Words): Four Thousand, Five Hundred Only Total Amount: 4,500
I solemnly declare that the entries made in this form are correct. In case of any false statement, I may held responsible.

Signature of Attesting Authority

NAME: .......................................................
CNIC NO: .................................................. STAMP Candidate Signature Candidate Thumb

Name: Ulfat Hussain Name: Ulfat Hussain

Father´s Name: Tariq Mehmood Father´s Name: Tariq Mehmood
Postal Address: house number f/570 Manzoor Hayat Postal Address: house number f/570 Manzoor Hayat
Colony Bhalwal, district Sargodha Colony Bhalwal, district Sargodha

You must have to provide attested copies of ("CNIC" or "Form-B"), certificate of above mentioned "Academic records" (e.g. Matric, Intermediate etc...).
Hard Copy of Registration Form must be dispatched to mentioned address along with all above mentioned documents:
Deputy Registrar (General), Registration Branch, Admin Block, Quaid-e-Azam Campus,
University of the Punjab, Lahore.

Page 1 of 2
 UNIVERSITY OF THE PUNJAB
(REGISTRATION BRANCH)

1 2 7 0 0 0 8 1 5 8
Application Form for Registration of Private Candidate for Associate Degree in
Arts/Science/Commerce Examination 2022
Note: If a candidate is already registered in the University of the Punjab, either as Regular or Private he should not submit the
Registration Form again.

Form No.: 0008158 (15/12/2021 11:53 AM) Received & Checked By:

PERSONAL RECORD (As Per Previous Exam Record)

Name: Ulfat Hussain CNIC: 38401-5985442-3
Father Name: Tariq Mehmood Father CNIC: 38401-3763347-5
Date of Birth: 16/11/2001 Religion: Islam
Contact No.: 03046734797 Gender: Male
Present Address: House Number F/570 Manzoor Hayat Colony Bhalwal, District Sargodha
Permanant Address: House Number F/570 Manzoor Hayat Colony Bhalwal, District Sargodha

FEE RECORD
Bank Branch Challan No. Date Amount
HBL 0589 Shahrah-e-liaquat Bhalwal 817913 15/12/2021 4,500
Total Amount (In Words): Four Thousand, Five Hundred Only Total Amount: 4,500
I solemnly declare that the entries made in this form are correct. In case of any false statement, I may held responsible.

Signature of Attesting Authority

NAME: .......................................................
CNIC NO: .................................................. STAMP Candidate Signature Candidate Thumb

Page 2 of 2
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