College of Medical laboratory Technology, National Institute of

Health, Islamabad
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Application for Admission in HSSC/04 Years BS-AHS

Medical Laboratory Technology
Bank Draft No: Dated
Name of the Candidate:
Father’s Name:
Date of Birth: Nationality:
Religion: CNIC NO:

Residential Address:

Telephone No: Mobile No:

E-Mail :

Academic Record:

S. # Qualification Major Subjects Year of Board / Institute Marks

Passing
1. SSC
2. HSSC
Service Record of Government nominee

S. # Institute Designation Service Period

1.
2.
Certified that all of the above information is correct to our best knowledge and belief

Signatures Applicant Parent/Guardian

Note: Please Attach two recent attested photographs and attested documents of other supporting documents (i.e.B-form,
Character Certificates, SSC DMC/HSSC DMC for BS) along with the pay order of Rs 800/- favoring Principal CMLT
NIH, Islamabad.
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Application Form Receipt

Student Name: _______________________ Father Name: ________________________

Received by:__________________________ Date:______________________________
Remarks of the department deputing the candidates for training (for in service candidates only):

Signature of the Office Incharge.

Declaration:

I Certify that I am applying for admission with the consent of my parents/guardian, and that the
particulars given overleaf are correct. I promise that during my stay in this college I shall conduct my
studies with honor, and will not take part in any political/unlawful activities.

I further undertake that I shall abide by all the rules and regulations laid down by the college from time to
time in correction with the residence, Studies and conduct, etc of the students.

I further undertake that if I am found involved in any unlawful activity or providing incorrect information
at any stage of study, the college shall have the right to cancel my admission without assigning any
reason.

instructions:

1. This form should be completed, in full, type written or by hand (in capital letters) and should be
submitted to college on or before the last date given in the advertisement.
2. Departmental candidate should apply through proper channel. Advance copies are accepted for
merit preparation, the nomination should reach within seven days after receipt of this application.

Otherwise application will be rejected/canceled.

Signature of Candidate Signature of Father/Guardian