Lahore University of Management Science 1 Photograph

Application form for National Outreach Programme

Batch-11 Paste here with glue

Who can apply?

Applicants should have atleast 80% MARKS IN MATRICULATION in order to apply for the NOP.
Moreover, NOP is a NEED BASED SCHOLARSHIP. Only genuinely financially deserving students will be
considered for the Programme.

Instructions for the submission of application form:

Please follow these instructions carefully:

 Fill in the form using a black pen.

 Fill the form in BLOCK LETTERS.
 Write your name and date of birth in the back of each picture.
 Fill the form completely; INCOMPLETE forms will not be processed.
 Attach all the required documents, application forms without Complete Documents will not be processed.
 Application Form along with all the required supporting documents should reach LUMS Admissions Office latest
by February 03, 2011.

 CHECKLIST OF THE REQUIRED DOCUMENTS:

Please mail all the required supporting documents (mentioned below) along with the application form in a
single envelope to the mailing address given below in the box:
Three attested latest passport size photographs
Attested copy of Matriculation/O level result card
Attested copy of National Identity Card (NIC) of your parents/guardian
Income certificate of your parents/guardian*
Note:
* An income certificate is the document that shows monthly/annual income. If your parents/guardian are
salaried, an original copy of a pay slip can be attached, otherwise if your parents/guardian own a business
they can submit Bank Statement for the last six months. If parents/guardian does not fall in either of the
above two cases (that is salaried employee or business man) they can submit an undertaking on a stamp
paper/affidavit (of Rs.20) stating their income and income source.

In case of providing false information, candidate will be disqualified and his / her application will not
be considered.

Mailing address is given below:

2 Photographs
Ms. Bushra Tasleem
Office of Admissions
Lahore University of Management Sciences Staple here
Opposite Sector U, DHA, Lahore Cantt. 54792

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PERSONAL DETAILS : (Please use BLOCK LETTERS to fill the form)

Forms with incomplete information will not be processed.

Name:

Father’s Name: Guardian’s Name:

Date of Birth
Father’s / Guardian’s NIC #: (of student): ______/______/______
(Provide a copy of NIC) dd / mm / yy

Mailing Address: (All future correspondence will be made on this address)

CITY: DISTRICT: PROVINCE:

Phone #: /
(City code) Mobile #:

Permanent Address: ( If different from the mailing address)

CITY: DISTRICT: PROVINCE:

Phone #: /
(City code)

Email*:
* It is mandatory for you to have a valid email address as well otherwise your form can be considered INCOMPLETE.

Do you have internet access at home or near your YES NO

house?

EDUCATION

Attach an attested copy of all the result cards with your application form.
Marks/ Grades School / College

Matric / O-level

Intermediate / A-level 1st year

2nd year

Stream Pre-Medical Pre-Engineering General Science Arts/Commerce Other

Is any member of your family currently studying at LUMS? Yes No If yes, state name and roll number:

Name Roll No:

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Give details about yourself and your siblings*:

*Siblings are brothers and sisters

School / College / Annual Parents

University Fee Scholarships Contribution
Name Age (If still studying) (in Rs) (in Rs) (in Rs)

Give details of teacher / headmaster / principal of your institution who knows you personally.

Name: School:

Address:__________________________________________ Tel:________/_____________
(city code)

Email address:

FINANCIAL DETAILS

a. ASSESTS: Houses, plots and other property owned by the family

Current Value Area Location
Assets Title Asset ( in Pakistan ( in Kanals/Marlas
Ownership** Rupees) or Sq. Feet)
i. House

ii. Land / Plot

iii. Agriculture

iv. Commercial

**In this column provide information about who owns the specific asset. It can be your father, mother, brother or
grandfather etc.

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 b. INCOME
(Give annual figures for items i, ii, iii, iv v)
Guardian’s / Brother’s
Income Source Father’s Mother’s & sister’s

Profession
i. Agricultural income
(Annual)
ii. Salary / Pension
(Annual)
iii. Returns on Saving
& Investment (Annual)
iv. Rental
Income(Annual)
v. Business Income
(Annual)
Total (I, ii, iii, iv & v)
A: B: C:
Total Income: (A+B+C)

How many air-conditioners do you have in your house?

Details of vehicle Owned by Family
NO Type of Vehicle Make and Model

c. EXPENSES

Annual Educational Expenses Annual Medical Expenses

Transportation / Food /
Traveling Expenses / Other
Annual Rent (If Living in a Rented House) Expenses ( per Annum)

Annual Taxes Annual Electricity Bills

Annual Telephone Bills Annual Water/Gas Bills

d. LIABILITIES

Are there any outstanding loans? Yes No If yes then:

i) Please indicate the amount of loan in Rs.________________________.

ii) And also please specify the purpose for taking the loan ___________________

iii) The source from where loan was taken

Bank * Relative Employer* Other (Please Specify):

* Kindly attached the supporting documents in case the loan is from Bank or Employer.

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TUITION EXPENSES:

 Tuition Fee for the first year at LUMS is Rs 400,000/- approximately

 Please Indicate the total amount of contribution you can make towards

your tuition fee annually at LUMS Rs________________

TEST CENTER:
Please choose one of the following centers for Preliminary Evaluation Test

Gilgit Peshawar Rawalpindi Lahore Faisalabad Multan

Quetta Hyderabad Karachi Sukkur Gujranwala Skardu

Why do you require financial aid (Attach separate sheet if required)?

How did you get to know about National Outreach Program? (Tick any one of the following)

Friends/Relatives Newspaper Add LUMS website

Information Session at School/College.
Kindly mention the School/College Name where you attended the session:_________________________________________
Other(Please Specify): ___________________________

Undertaking:
I certify that the information given on this form is accurate to the best of my knowledge. I
understand that any misrepresentation may cause my dismissal from the Programme at any stage.

________________________ ________________________
Applicant’s Signatures Father/Guardian’s Signature

Date: ______/______/______ Date: ______/______/______

dd / mm / yy dd / mm / yy

For enquiries regarding your application form contact us at:

Phone: 042-35608000, ext: 2407

Fax: 042-35898317, Email: nop@lums.edu.pk
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