APPLICATION FORM

FOR ADMISSION AS OVERSEAS STUDENT

IN MBBS / BDS (Session 2013)

at DOW INTERNATIONAL MEDICAL COLLEGE (DIMC) and DOW INTERNATIONAL DENTAL COLLEGE (DIDC)

Scan Photograph if sending by e-mail

DOW UNIVERSITY OF HEALTH SCIENCES, KARACHI

NOTE: Overseas seats at Dow Medical College will be offered on Merit cum choice basis to these candidates.
Please tick the category of seat opted: FILL THE FORM IN BLOCK LETTERS.

MBBS

BDS

any

Name of Applicant Birth Date Birth Location

Fathers Name Birth Country Marital Status Age on closing date Religion Tel No. Mobile: Male Female

CNIC NICOP Home Address

(Present)

Home Address
(Permanent)

E-mail:

Single Nationality Dual

Name of Country

Passport No. Place of Issue

Date of Issue Expiry date

ACADEMIC RECORD
Grades / GPA / Marks Grades / GPA / Marks SUBJECTS Obtained in 9th + 10th Grade OR O Level OR Matric Biology Chemistry Physics/Math Year of Passing Obtained in 11th + 12th Grade OR A Level OR Interscience
Do you have SAT II Science Scores in 3 Subjects If (No) do you intend to appear in SAT II Yes No

Grades / GPA Advance Courses (If taken)

Do you have IBCC Equivalence Certificate

Yes

No

If (No) did you apply for it

Yes

No

Yes

No

(Biology, Chemisty, any other subject)

If (Yes) when? Yes No

Have you applied elsewhere for Admission ......... Yes (If Yes please mention details:

No

If admitted will you be able to join from the start of session 5th Oct. 2013 ............ Yes (If No then when mention, Possible date of joining: Name and Address of School (9th & 10th grade / O Level / Matric) Name and Address of College
(11th & 12th grade / A Level / Interscience) Name of University for (Advance) Course (If Studied) You need Hostel Accomodation (Details on website)------------- Yes

No

No

Fathers Particulars
Name Nationality / Citizenship Place of Domicile If dual Passport
(Mention Country)

Religion Mobile No. Passport No.

(Pakistan)

Tel. No. E-mail: Place of Issue Profession Date of

Expiry

Qualification Position Employer / Company

Yes No Yes

Occupation Sector Have you been visiting Pakistan?

How much time you have spent (in Pakistan)

No

Do you have any close relative in Karachi?

(If yes) His / Her Contact No.

Any Brother / Sister studying in Pakistan? If yes, where and in which program? The progress or the complaints of your Son / Daugher should be communicated to both (father and guardian)
Yes No

Guardianss Particulars
Name Nationality / Citizenship CNIC No. Passport No.
(Pakistan)

Religion Mobile No. Place of Domicile Place of Issue Profession Employer

Tel. No. E-mail:

Date of
Expiry

Qualification Designation

Occupation Relationship with Candidate

NOTE: INCOMPLETE FORM MAY NOT BE ACCEPTED

Documents Submitted
Certificate / Diplomas Uptil 12th Grade OR A Level OR Interscience 12th Grade OR A Level OR Interscience
(Transcript / attached)

Yes

No
Left hand thumb impression of Applicant

Transcript of

Yes

No

If AP Courses attended

Yes Yes Yes Yes Yes Yes

No No No No No No
Fathers / Guardian Signature Applicants Signature

Copy of Passport of Candidate Copy of Passport of Father Copy of CNIC / NICOP (Candidate) Copy of CNIC / NICOP (Father) Copy of IBCC Equivalence / SAT II Scores

(If not then undertaking to be submitted with possibel dates)