GOMAL UNIVERSITY, DERA ISMAIL KHAN

APPLICATION FOR ADMISSION

S.No.______

Name of Institute/Department / ______
Program

PERSONAL DATA:


1. NAME:
2. FATHER’S NAME:
3. FATHER’S OCCUPATION: / 4. FATHER’S
MONTHLY INCOME:
5. FATHER’S NIC: / – / –
6.  GENDER: / M / F / 7. DATE OF BIRTH: (dd/mm/yyyy) / / / /
8. APPLICANT NIC: / _ / _ / 9.  Marital Status: / Married / Un-Married
10. TELEPHONE:
with area code / 11.  MOB.: / - /
12. RELIGION: ______/ 13. DOMICILE: ______
14. E-MAIL: (In block letters) ______/ 15. NATIONALITY:______

16. University / Board Registration No. of Previous Class:

17. PERMANENT ADDRESS:

______

______

18. MAILING ADDRESS: (If different than above)

______

______

19. ACADEMIC RECORD:

Examination Passed / Year / Examining Body / Roll No. / CGPA/Marks / Division / Major Subjects
Obtained / Total
Matric/O level
FA/FSc/A level or Equivalent
BA/BSc or Equivalent
M.A/M.Sc/BS (4-year) or Equivalent

20. ENTRY TEST RECORD (if already passed)

Test Type / Roll No. / Score / Field of Study / Test Date / Valid Upto
NAT-I (For BS (Hons))
NAT-II (For Master Program)
Are You employed? If yes, give details. / Yes / Designation
No / Organization

INSTRUCTION FOR APPLICANTS

1.  All entries in the form must be made in block letters by the candidate in his/her own handwriting.

2.  Incomplete applications will not be entertained.

3.  See the prospectus to choose program(s) and its eligibility.

4.  Use another admission form for different program.

5.  Each part/column of the application is to be filled, if any part/column is not applicable, write “N/A” against it.

6.  Any candidate found to have made false or incorrect statement in this form his admission will be cancelled.

7.  Copies of all relevant documents must be attached with the application form.

8.  No benefit would be given for any document not attached with the application or produced after the closing date.

9.  Unattested Copies of the Documents are not acceptable.

10.  Application Form shall be submitted by hand in the Admission Office at City Campus, or sent through Registered Post/ Courier Service. Time barred application will not be entertained.

11.  CHECK LIST: Please Check; have you attached the following documents with the Application Form?

Sr.# / DESCRIPTION / Yes / No
1. / Attested copies of all the educational documents with DMCs listed at Sr. No. 19 & 20
Note: Attach both Bachelor’s Part-1 & Part-2 DMCs for Master Admission
2. / Copy of CNIC.
3. / Domicile Certificate
4. / Character Certificate
5. / Three recent passport-size photographs.
6. / Original Migration Certificate (if applicable).
7. / NOC from the Parent Organization (for employees only).
8. / Any Other documents Please Specify. ()

UNDERTAKING

1.  SOLEMNLY DECLARE THAT:

i.  I have neither joined nor shall join any other Institute during the course of my studies at the university.

ii.  I am not in service /am in service. (A letter of permission from the Parent Organization is enclosed).

iii.  I am not suffering from any infection disease.

iv.  The entries made in this form are correct.

SIGNATURE OF THE APPLICANT

Date: ______