DIYA PAKISTAN REGISTERED

1304/474, Hasan Street, Defence Road, New Lalazar, Rawalpindi Tel: 051-5859582, Mobile: 0300-5322592 (Office Telephone Timings: 3:00pm to 5:00pm) Attach a scanned copy of the front side of your CNIC along with this form. 1. APPLICANT'S DETAILS Name: CNIC No: Umar farooq 32101-7997897-9 Ghulam Qadir sakina bi bi 42201-8200861-5
Male Female

Age: 21

Father's Name: Mother's Name: Father's CNIC No: Gender: Email:

Mother's CNIC No: Domicile:

32101-5303091-8

tribel area of d.gkhan Tel: 3346764543

Umar_uet@yahoo.com

Present Address:

umar farooq C/O makkah institute of technology water suply No.1 near railway ground chakwal dist: c

Permanent Address:

basti bajha p/o vahoa tehseel tribal area dist: D.G.khan

Applicant's Status:

Orphan

Disabled

Poor & Deserving

Orphan's Only: Mention year of father's death: Disabled Only: Indicate nature of disability:

2. COURSE DETAILS Name of University / College: Title of Programme / Course: Roll No: 10-ECT-21 11/24/2010 UET Taixla sub campus chakwal Bsc.Electronics Engg Registration No: 10-ECT-21 will complete on: Years: 4 6/15/2014 Semesters: 8 2
Reserved Seats Self Finance

Programme started on:

Total Duration of your Programme / Course: Currently Enrolled in Year / Semester: Mode of Admission:
Open Merit

Key person to be contacted in your department: Name: Designation: sir Ahmad umar niazi Chairmain of Electronics Department Tel: 3014481145

3. ACADEMIC RECORD Examination Matriculation Intermediate Marks Obtained 698 892

Year 2008 2010

Roll No. 70997 47215

Total Marks 850 1100

% 82.11% 0.81

Position nil nil

Are you Hafiz-e-Quran? Do you retain Hifz? Current Academic Performance

Yes
Yes

No
No

Provide complete details of all examinations that have been administered by your university / college so far, including examinations for which the result has not been declared yet. Examination Level (Mention Year, Prof or Semester) Month / Year when exam was conducted Results Declaration Date / Status Average Percentage or GPA obtained

4. GUARDIAN DETAILS Name: Relationship: Designation & Grade: Ghulam Qadir Father Occupation: CNIC No: 42201-8200861-5

Retired from p.a.f Organization / Dept.: PAK P.A.F 10000 10000

wrant oficer Retired &14

Total Gross Monthly Income (Salary / Pension / Others): Total Net Monthly Income (Salary / Pension / Others):

Note: For occupation, be exact. Do not say Government Servant, pensioner, worker etc.

5. EDUCATIONAL EXPENDITURE Current Expenses on Education Yearly Tuition Fee 34000 Yearly Hostel Fee 24000 Yearly Messing Expenses 30000 Total Expenditure 88000

Sources of Educational Financing other than Guardian's Monthly Income Loan from Relatives / Friends / Organization Scholarship from another organization Remission from College / University Income from other sources yes get loan from cousin to pays universty fee nill nill nill

If you are receiving scholarship from another organization, then please provide the details: Total Amount of Scholarship: Name of the Donor / Organization: Type of Scholarship:
One-time

nill nill
Yearly Monthly

If you have stated any amount for 'Income from other sources', then provide complete details of all such sources: nill

Tuition Fee & Other Expenses of Institutes Previously Attended Matriculation Name of the Institute Location Yearly Expenses Amount of any Scholarship / Remission Availed govt high school vahoa d.gkhan nearly 15000 Intermediate govt degree college vahoa D.G.khan 30000

nill

nill

Note: For matriculation you should state the yearly expenses you had to incur in class Xth only. Similarly, for Intermediate you should state the yearly expenses of class XIIth only.

6. HOUSEHOLD DETAILS (Note: Family includes father, mother, brothers and sisters) Family House Type: Status:
Rented House Flat Family Owned Quarter Mud House

Provided by Govt. / Organization

If own house, give details: Total constructed / covered area in Square Ft.: If rented, annual rent: nill 1250 40 Total Area in Sq. Yards: 12

Total amount of electricity bills from April to September (6 months):

Details of family members currently employed / retired Name Age Exact Designation Employer
Gross Monthly Income

Details of family members currently engaged in business / commercial activity Name Age Type of Business Location of Business
Gross Monthly Income

Details of family members currently studying Name Age Full Name of Institute Yearly Expenses

7. FAMILY ASSETS

Does the family own transport?

Yes

No

If yes, give details i.e. Motorcycle, car, rickshaw, pick up, truck, tractor etc.

Details of property owned by the family: Property Type Land / Plots Shop (Commercial) Family House Any other thing that you would like to add or say (related to this application): Area Total Worth in Rupees

Declaration by the Applicant and his/her Guardian: We, the undersigned solemnly affirm that the details/information provided are accurate and that we shall be responsible for any inaccurate or false information.

Applicant's Signature

Guardian's Signature

Verification by Tehsildar or Competent Authority: I attest that the information contained in application form is accurate and the applicant deserves the grant of scholarship award.

Signature

Stamp / Seal

Note: Competent authority includes Area Magistrate, Tehsildar, Naib Tehsildar, Mukhtiarkar or Area Nazim

th this form.

For Diya's Office Use Only Decision

Reason (if required)

History Previous Folio Last Disbursement

Required Docs

Disability Cert

Hifz Cert

Semester Results

Bachelor's

Income Certificate

Siblings Fee Receipts

Flood Attestation