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Indigenous PhD Fellowship Program

Application ID:

HEC/HRD/I5000/2015/21538

Submission Date:

13-Dec-2015

Print Date:

14-Dec-2015

Payment Information
Bank Name:
City:
Branch:
Amount (Rs.):
Pay order/Demand draft/Online receipt number:
Dated:
Please tick the Preferred Test Center:
Islamabad

Lahore

Karachi

Peshawar

Quetta

Please be careful in selecting the TEST CENTER, because in case of omission and wrong entry. TEST CENTER
WILL NOT BE CHANGED. Otherwise you will not be considered/called for the test/scholarship.

Personal Information
Name

Mr. Shamsullah Khan

Nationality

Pakistan

Gender

Male

Date of Birth

18-Jan-1986

Place of Birth

Pakistan

Marital Status

Single

CNIC/Passport

11201-3909541-7

Domicile District

Khyber Pakhtoonkhah

Scholarship Information
Discipline

Business education

Category

Bachelor/ Master 16 years completed

Enrolled/Intension to
Join

MS/MPhil

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University Name

Gomal University, D.I. Khan

Disabled

No

Contact Information
Contact Type

Contact Value

Primary Email

shamsullah_r@yahoo.com

Cell Phone

+923449334640

Address Details
Address Type

Address

Permanent

Village Hakim Khan Ahmad Zai Post Office Tajori

Academic Details
Field of Study

Start Date

End Date

Total
Obtained
Marks/GPA Marks/GPA

Degree

Institute

Secondary School
Certificate / NonMatriculation

BISE Bannu

Other

01-Apr-2000

18-Jun-2002

850.00

563.00

Higher Secondary
School Certificate

N.W.F.P Technical
Board

Other

14-Jul-2002

23-Jul-2004

1400.00

794.00

Bachelor's 14 Years
Degree

Gomal University, D.I.


Khan

Other

18-Aug-2004

25-Aug-2006

1400.00

813.00

Master / Bachelor 16
Gomal University, D.I.
Years Degree / Master
Khan
(H) 16+ / PGD

Other

14-Sep-2006

15-Sep-2015

2100.00

1617.00

Professional Training/Certificates

Employment Details

Publication Details
Additional Information
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Cover Letter
Dear Sir/Madam,
I hereby submit my application form under Indigenous 5000 PhD fellowship program Phase II, Batch III.
Thank You.
Regards,
Mr. Shamsullah Khan
14-Dec-2015

Document Checklist
Title

Is Attached?

Photocopies of all educational testimonials attested by Gazetted officer.

YES

Attested Copy of domicile.

YES

Attested Photocopy of CNIC.

YES

One Passport size Photograph.

YES

NOC for In-Service Candidates

YES

Original online deposit slip /ATM Transfer Slip of Rs. 500/-(non-refundable).

YES

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Disclaimer
The statements made by me in the forgoing columns are true to the best of my knowledge and belief. It is solemnly affirmed
that I have read and understood the conditions of the award of this program advertised in the press and from the web page
of HEC Indigenous Scholarship Program and that the decision of the National Scholarship Management Committee (NSMC)
would be Final and binding. I understand that the award will be withdrawn as well as recovery of full amount spent on me in
the connection with the award if any misrepresentation or omission is discovered even after my selection for fellowship
award under the indigenous PhD Fellowship Scheme.

Signature:
Date:
Shamsullah Khan

Higher Education Commission, H-9, Islamabad (Pakistan)

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