Higher Education Assistance - Registration Form

Personal Information

Name *

Mr. furqan hassan hassan

Title First Middle Name Last

Email *

furqan.hassan521@gmail.com

CNIC *

4210191644935

Select the relevant option *

Syed

Non Syed

Contact No *

+92 03463234390

Date of Birth *

05-Oct-2001
dd-MMM-yyyy

Marital Status *

Single

Address *

121/2 sector 5-d new karachi

Street Address

Address Line 2

karaci Karachi
City State/Region/Province

75853 Pakistan
Postal / Zip Code Country

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LinkedIn Profile

Proposed Course or Degree Detail

Which Course or Degree You Are Applying for? *

BSCS

Name of the Institute or University *

federal urdu university

Expected Course or Degree Commencement Date

dd-MMM-yyyy

Expected Course or Degree Completion Date

dd-MMM-yyyy

Have you received any Grant or Scholarship from University? (if Yes, then mention in %)

Why have you chosen this program and university? *

intrested in computer science

Have you received your Admission Letter? If Yes, please attach *

Yes

Duration of the Course (in Semesters) *

Fees Per Semester in Pak Rupees *

39,000.00 PKR

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How will you arrange remaining Fees and other cost, if only partial fees will be given as loan?*

loan from friends and family

University Bank Details (if available)

Street Address

Address Line 2

State/Region/Province

-Select-
Country

Name of the Account Holder

Account or IBAN Number

Previous Education Details

Under-Graduate Academic Education Details *

Name of the Institute Year of Passing % or GPA

Matric * dhaka secondary school 2018 82%

Inter * BIEK 2020 63%

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Graduate and Post Graduate Academic Education Details

Name of the Institute Year of Passing % or GPA

Graduation

Post Graduation

Other

Family Information

Number of Family Members Living with You *

3 Members

Ownership of House *

Owned by Parents or Immediate Family Member

Name and Amount of Family Members Earning *

Total Income in PKR

Father * 5000

Mother * 0

Siblings * 50000

Self * 8000

Total Family Income * 63000

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Family Expenses *

Expenses in PKR

Rent * 0

Utility * 20000

Education * 39000

Transport * 10000

Other House Expenses * 5000

Loan Repayment * 0

Other Expenses * 0

Total Expenses * 74000

Have your Family availed any welfare or education scholarship previously from KPSIAJ or its subsidiaries? (if Yes,
please provide details) *

no

Family Loan Details *

From Banks From Any Community Organization

Amount Remaining * 0 0

Monthly Repayment * 0 0

Guarantor Information

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Information (Not required from Syed Applicants)

Guarantor No 1 Guarantor No 2

Guarantor Name

Guarantor Designation

Guarantor Organization

Guarantor CNIC Number

Guarantor Contact Number

Guarantor Email

Guarantor Gross Monthly Income

Attachments

Your Photo (Females Photos Must be in Islamic Hijab) *

passport_photo.jpg

Last Accomplished Degree or Transcript *

transcript_firsr.jpg

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Written Letter of Admission (if given)

Choose File

Last Month Electricity Bill *

0403202421-DuplicateBill-Jan-2024-0400019585539.pdf

Guarantor 1 Last Salary Slip or Six Month Bank Statement

Choose File

Guarantor 2 Last Salary Slip or Six Month Bank Statement

Choose File

Terms and Conditions *

1. I hereby confirm I understand this form and all the information contained on this application form is to the best of my knowledge and
belief, true and correct.
2. I agree to abide by all terms and conditions stated in the form once my application be approved.
3. I do not have any objection of sharing my details with the authorities as required by the law of land and with the charity regulations,
where applicable, and any other entities whenever required.
4. I also allow sharing my relevant data to donors and relevant parties for marketing and reporting purpose.
5. I also understand that the payments (full or partial) will be directly made to my University Bank Account and will not be made to any
Personal Account. For this, I also undertake to provide relevant details well ahead of time.
6. I undertake to share my results at the end of each term, promptly and without reminders or will share concerns with SLC without any
delay.
7. I will share all other grants or loans or scholarships I receive with respect to the current education, either before or during the term of
my loan.
8. In the event, I fail to report or repay, the authorize persons reserve the right to directly contact with my Institute or University or any
other relevant organization for further information.
9. I also undertake, not to transfer my course to any other educational institute, not to change the course of study or degree for which
they are given loan, without the prior approval of KPSIAJ Scholarship and Loan Committee (SLC).
10. If I fail to complete my course, for whatever reason, I undertake to inform KPSIAJ Scholarship and Loan Committee (SLC) and
immediately repay the outstanding loan.
11. I also undertake to inform any changes in my current addresses or contact details or any circumstances that may affect the course or
loan repayments during the duration of the course.
12. Upon completion of the course, I am required to share my immediate career plans and thereafter keep update regarding any changes
in my addresses or employer details.
13. I, further take an oath in the name of my religion, ISLAM and faith SHIA ITHNA ASHERI that having received the loan, I shall repay the
loan as per schedule. May the Almighty help me to keep my oath and to fulfill it for His pleasure.

I accept the Terms and Conditions.

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