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) This Form must be submitted via email to apply@diyapak.org 1. APPLICANTS' DETAILS Name: CNIC No: Father's Name: Mother's Name: Father's CNIC No: Email: Present Address: Mother's CNIC No: Tel: Age:

Permanent Address:

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 For applicants continuing the same course as before: Currently Enrolled in Year / Semester: For applicants who have completed their previous course and have now started a new course: Name of University / College: Title of Programme / Course: Roll No: Programme started on: Total Duration of your Programme / Course: Currently Enrolled in Year / Semester: Mode of Admission:
Open Merit Reserved Seats Self Finance

Registration No: will complete on: Years: Semesters:

3. ACADEMIC RECORD Examination Bachelors (if applicable) Are you Hafiz-e-Quran? Do you retain Hifz? Current Academic Performance 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
Yes Yes No No

Year

Roll No.

Marks Obtained

Total Marks

Position

4. GUARDIAN DETAILS
There has been no change in the information provided last year, hence I'm leaving the guardian details as blank.

Name: Relationship: Designation & Grade: Occupation:

CNIC No:

Organization / Dept.:

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 Yearly Hostel Fee Yearly Messing Expenses Total Expenditure

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 Yearly Monthly

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

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

Attestation Status Stipend Folio Previous Case

Required Docs

Disability Cert

Hifz Cert

Semester Results

Bachelor's

Payment Voucher

Siblings Fee Receipts