Application No.______

(To be filled by SBBU, SBA) .

/ SHAHEED BENAZIR BHUTTO UNIVERSITY, SHAHEED BENAZIRABAD
APPLICATION FORM
Faculty Development Program(FDP) Scholarships for Ph.D Studies (Local)

Please tick þ the choice of scholarship

1. Payment Information: (Tick þ the relevant category.

Bank Draft Rs. 1000 in favor of Director Finance, Shaheed Benazir Bhutto University, Shaheed Benazirabad
Draft No______Date:______Bank______

2. Please tick Ö your subject. Note: you can only choose one subject offered in the list. More than one ticked subject can lead toward rejection of application.

Field of Study:
Computer Science/ Information Technologies
Mass Communication/ Media Studies
Business Administration
English

3. Specific Area of Research: ______

4. Category (according to employment status): (Please tick only one)

a / Public Sector University / / b / Public Sector R&D Organization /
c / Public Sector College / / d / Public Sector Degree Awarding Institute (DAI) /
e / Private Sector University / / f / Public Sector Organization /
g / Private Sector Organization / Bank / / h / Any Other /

5. PERSONAL INFORMATION: (PLEASE USE CAPITAL LETTERS)

6. FULL NAME______

(As given in the Matric/SS Certificate)

7. FATHER’S NAME: ______

8. DATE OF BIRTH: ______9. AGE (On April 30, 2017): ______

(Day) (Month) (Year) (Years) (Months)

10. Marital Status □ Single □ Married 11. GENDER: □ Male □ Female

12. CNIC #: ______13. Passport #:______

14. POSTAL ADDRES: ____________

______CITY: ______

15. PERMANENTADDRESS:_________

______CITY: ______

16. TELEPHONE NO: (OFF) ______(RES.): ______(Mobile): ______

(City Code - Phone No.)

17. E-MAIL: ______(Mandatory, most of the future correspondence will be done using e-mail address)

18. Domicile: (City) ______(Dist.)______Province______

19. ACADEMIC RECORD

(Candidates from annual system must fill % marks & division whereas candidates from semester system should fill in CGPA only)

Certificate/Diploma/Degree / Major Subjects / Year of Passing / % marks obtained / Division / CGPA / Institution / Board/ University
SSC/Matric/’O’ Level
(10 years)
HSSC/Intermediate/’A’ Level (12 years)
Bachelors (BA, BSc, B.Sc(Hons), etc)
(14 & 15 years)
Bachelors (B.E, BBA, MBA, M.Sc B.Sc(Hons), etc) (16 years)
M.Phil/MS/ME etc (If Completed) (18 years)

20.  EMPLOYMENT STATUS:

Employer’s Name (College / University / organization) / Address of the Organization / Pay Scale / Designation / Period of Service
From / To
Current Employer
Last Employer (only last one)

21. TOTAL PERIOD OF SERVICE (in years):______

22. GAT (General) Score (For only those applicants who appeared in GAT (General) tests. Please attach copy of result card otherwise score will not be considered).

Roll No: ______

Name (As appeared in GAT result card): ______

Father Name (As appeared in GAT result card):______

Test Date: ______

(Day) (Month) (Year)

For only those candidates who have 50% (Accumulative Raw Score) or above marks

GRE / English / Analytical / Quantitative / Accumulative
Raw Score

23. UNDERTAKING BY THE APPLICANT:

It is solemnly affirmed that I have read and understood the conditions of the award of this program/scheme advertised in press and that the decision of Shaheed Benazir Bhutto University, Shaheed Benazirabad would be final and binding. In the event any information contained herein is found to be untrue, I shall be liable to disciplinary action, which may result in my termination from service, cancellation of scholarship and recovery of full amount spent on me in connection with this award.

I undertake that I am not currently recipient of any other HEC scholarship.

I also undertake that after completion of my studies abroad, I will come back and serve at Shaheed Benazir Bhutto University, Shaheed Benazirabad for 5 years. Shaheed Benazir Bhutto University, Shaheed Benazirabad reserves the right to appoint me in any department/ project keeping in view the national needs.

Date: ______Signature of the candidate:______

24. Only for Government Employees

(To be filled by the organization)

28. All candidates applying through proper channel may submit advance copy and this should be certified by Head of Organization.

ATTESTATION BY THE VICE CHANCELLOR / RECTOR / CHAIRMAN R &D ORG / SECRETARY (MINISTRY/DEPT/ ORGANIZATION HEAD.)

i) Certified that the statement made above has been verified and found correct. Attested copies of certificates, degrees along with copy of C.V. of the candidate duly verified are enclosed.

ii) Certified that Mr./Ms. ______is employed on full time/permanent basis at our university/college/organization since ______and he/she is not employed on ad-hoc/contract basis.

iii) It is further certified that the incumbent if awarded the Scholarship by Shaheed Benazir Bhutto University, Shaheed Benazirabad, he/she would Serve the Shaheed Benazir Bhutto University, Shaheed Benazirabad for 05 years after completion of Studies.

iv) After selection for the PhD degree he/she will be immediately released to join Shaheed Benazir Bhutto University, Shaheed Benazirabad.

Date: ______Signature ______

(VC/Rector/Chairman R & D Org. / Secretary/Organization Head)

Designation: ______

Office Stamp: ______


25. Study Objective: Write a clear and detailed description of your study objectives and give your reasons for wanting to pursue them. Describe the kind of program you expect to undertake and explain how your study plan fits in with your previous training and your future objectives.

Note: Please limit your response to the size of this page. Recommended Font size “Times New Roman, 12 points”

26. Please check the list of documents attached with the application form:

/ Attested photocopies of all educational testimonials. Equivalence of the foreign qualification/s from HEC will be required with the application form.
/ Attested photocopy of CNIC
/ CV/Resume
/ Research Proposal
/ NOC from the employer for in-service candidates (only for Government employees)
/ Attested Copy of GAT (General) score result card
/ Original Bank Draft of Rs. 1000/.

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