[Pak USAID Merit and Needs based Scholarship Program ]

Scholarship is based on assessment of need and merit as well as availability of funds. Selection will be decided on the basis
of information provided in this form and investigations for the authentication of provided information. Candidate may be
required to appear for interview(s).
INSTRUCTIONS FOR FILLING OUT THE SCHOLARSHIP APPLICATION FORM:
1.

Fill in the form using black ball point pen and write in
capital letters and leave space between words

7.

Check your application for spellings, grammatical

errors and factual oversight

2.

Read the application form carefully

8.

3.

Before filling the original form make photocopy and fill it

first

Keep a photocopy of the

application form for your record

9.

Ensure that you have attached all the required

documents by putting a tick mark in checklist

4.
5.
6.

Submit duly completed application form to the

Financial Aid Office along with supporting documents
Furnish factual, comprehensive
information in the form

and

filled-in

original

10. Answer all questions. Those not applicable should

be marked N/A

authentic

11. Affidavit Needs to be submitted after final selection

of the candidate. For family financial reporting
parents/guardian may be consulted for guidance

Whenever in doubt or lost, seek help from the Financial

Aid Office

Definitions:
Family: Father, mother(s), brother(s), sisters(s), Grandparents etc.
Pucca House: A pucca house is one, which has walls and roof made of the following material.
Wall material: Burnt bricks, stones (packed with lime or cement), cement concrete, timber, ekra etc
Roof Material: Tiles, GCI (Galvanised Corrugated Iron) sheets, asbestos cement sheet, RBC,(Reinforced Brick Concrete),
RCC ( Reinforced Cement Concrete) and timber etc.
Kutcha House: The walls and/or roof of which are made of material other than those mentioned above, such as un-burnt
bricks, bamboos, mud, grass, reeds, thatch, loosely packed stones, etc. are treated as kutcha house.
Semi -Pucca house: A house that has fixed walls made up of pucca material but roof is made up of the material other than
those used for pucca house.
Dependent Family Member: A family member is dependent if, he/she dependents upon applicant father/guardian to meet
his/her basic needs (food, clothing and shelter)
Do

Donot
1.

Send your application by post or submit by hand to the

admission office or focal person.

2.

Place documents in right .Put all amounts in Pak Rs.

3.

Do consult with parent(s)/guardian(s) for financial data

accuracy & reliability

4.

For the information not present/relevant write in capital

letters N/A

1.

Provide False/vague/ incomplete information.

2.

Please dont overwrite/ scratch on the form.

3.

Please do not send scholarship application directly to

HEC or USAID

Pak USAID Merit and

Needs based
Scholarship Form

Affix Passport Size Picture

1. General Information
University Name

Degree

Graduate

Undergraduate

Discipline

Engineering Medical Business Agriculture Veterinary Sciences Social Sciences :

Sub Discipline

Click here to enter text.

Program Duration

Current Semester

2. Applicant information
Candidate Name

Gender

Father Name

University
registration No

CNIC Number

Marital Status

Date of Birth
(dd/mm/yyyy)

Age

Nationality

Domicile

Male

Female

Single

Married

Divorced

[District Name,
Province]

Tehsil

Mobile No

Telephone

Email

(Area Code-Number)

3. Address
Present Address
[H no, St No, Mohallah City,
Country)

Permanent Address
Postal Address

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4. Previous Education of the Applicant

Level of Study

Name of the
Institution

Secondary School Certificate

Type of
Institution

Start- End Date

Public

Click here to enter a

date.

Private

Click here to enter a

date.

Private

To Click here to enter a

date.

Public

Bachelors

Click here to enter a

date.

Private

To Click here to enter a

date.

Public Private

Masters

Division/ GPA/
Grade

To Click here to enter a

date.

Public

Intermediate

Per Month Fee

Click here to enter a date.

To Click here to enter a
date.

5. Family information
Father Status

Alive Deceased Separated (if

Professional
deceased please share date of demise Status (if alive]

[Please attached the death

certified in case of applicant
Click
Father is expired]

Working Not Working Retired

here to enter a date.

Father CNIC

Profession

Public /Government Job

[if working]

Private Sector Job Business Farmer

Laborer Other Detail in case of Other
Click here to enter text.

Father/Guardians
Employer Name

Address of
Employer

[If working, Name of

Company / Employer, in
case of Retd Please share
last organization]

[Address, City,
Country,)

Father/Guardian
Designation

Mobile Number
& Telephone

[Please do mentioned the

Grade in Case of Public
Sector Organization, in case
of Retd Please share last
designation ]

[Area Code-Number]

Father/Guardian NTN
Number and Tax paid

Financial Support Mother(s) Brother(s) Sister Uncle(s)

other than father Aunt(s) Other Not Applicable
Income[Please

[Please attached the Latest

tax return ]

Mother Status
[Please attached the death
certificate]

check the relevant

boxes ]

Alive Deceased Separated (if

Mother Status:
deceased please share date of demise

Working
Not Working

Click here to enter a date.

Marriage Relationship Combined Separated

Mother
Profession
[If working]

House wife Private Sector Job Business

Farmer Laborer Tailoring Not applicable
Other Detail in case of Other Click here to
enter text.

Page | 3

6. Family Members
Total Family Members

Dependent
Family Members

Total Earning
Member(s)

Family Member
Studying

No of Brother(s)

No of Sister(s)

7. Family Income (Add extra sheet if required)

Name of earning person

Profession

Financially
supporting the
family

Relationship with
Applicant

Yes No

Relationship.

Yes No

Relationship.

Yes No

Relationship.

Gross Income

Total
Please attached the Latest Salary Slip\income certificate with application Form

8. Current Monthly Educational Expenditure

Name

Relationship
with
Applicant

Institution Name

Class

Per Month
Education
Expenditure

Relationship.

Relationship.

Relationship.

Relationship.

Relationship.

Total(Per Month) [Please convert semester, bi annual

expenditure into monthly expenditure ]

Name

Per Month Education Expenditure

Self( Please include expenditure including tuition fee and lodging charges)
Page | 4

9. Monthly Family Expenditure

Detail

Per Month Amount

Average Telephone bill of last Six months

Click here to enter text.

(Please attached Bills with application form]

Average Electricity Bills bill of last Six months
(Please attached Bills with application form]
Average Gas Bills bill of last Six months
(Please attached Bills with application form]
Average Water Bills bill of last Six months
(Please attached Bills with application form]
Average Monthly Mobile Bill
Average Family Educational Expenditure other than applicant
(Please Ref S no 8 previous page]
Applicant Educational Expenditure
(Please Ref S. no 8 previous page]
Average Family Expenditure on Kitchen/Food
Average Family Medical Expenditure
(Please attached Bills with application form]
Accommodation Expenditure , in case of rent
(Please attached rent agreement]
Average Family Misc. Expenditure
Total Monthly Expenditure

Detail

Per Month Amount

Net Income(Total Monthly Income Total Monthly Expenditure)

[Ref point 7 and above block]

10. If the monthly I ncome is negative kindly explain the reasons for the gap, and the arrangements
through which the differential gap is met by the family

Click here to enter text.

Page | 5

11. Accommodation
Type

Bungalow Apartment Flat Village

House Town House

Structure of
House

Pucca Semi Pucca Kutcha

Status

Self Owned Family Owned

No of Rooms

Rented Employer Owned

2-3
4-6
6-8
Above 8

Size of Home

Covered Areas

[in Sq. Ft]

[in Sq. Ft]

No of Air Conditioners: 0

Number of
Servants

1-2
3-4

0
1-2
3-4 Above 4

5-6 7-8
Above 8
Monthly Rent

Address

[if applicable]
Any other house/flat owned by the Parents/Guardian (if yes please specify with location and size)
Click here to enter text.

12. Assets
Does the family own any Transport Yes No, if yes please fill the following
Type of Transport

Engine
Capacity
CC

Quantity

Current
Market Value

Choose an item.
Choose an item.
Choose an item.
Total Value of Transport

Does the family own any cattle Yes No, if yes please fill the following
Type of cattle

Quantity

Current
Market Value

Page | 6

Total Value of cattle

Other Assets

Quantity

Current Market Value

Does the family own any Stocks/Prize bond Yes No

(if yes please fill the next columns)
Does the family own any Bank Balance Yes No (if yes,
please fill and attached the statement)
Does the family own any Plot Yes No (if yes fill the next
columns)

Size in Sq Ft

Does the family own any House Yes No (if yes fill the
next columns)

Size in Sq Ft

Does the family own Yes No any Agriculture Land (if

yes please fill the next column)

Size:

Any other asset

Total
Any other financing other than this scholarship (Please specify)
Click here to enter text.

How were the admission /first semester charges paid?

Have you ever awarded any other scholarship before ,if yes please share the details

Statement of Purpose (attach separate sheet if required)

Under taking

Page | 7

1.

The information given in this application is true to the best of my knowledge and I understand that any incorrect information will result
in the cancellation of this application. If any information given in this application is found incorrect or false after grant of financial
assistance, the institute will stop further assistance and the student will have to refund all payment received and or penalty equal to
total scholarship amount.

2.

HEC and University reserves the right to use information given in this form for verification and other purposes

Date

Date

Father/Guardian
Signature

Applicant
Signature

13. Please attached pictures showing inside and front view of your House (Optional)

Outside view

Inside view

Page | 8

14. Check List

Documents

attached

Copied of CNIC

Documents

Attached

Copies of last six (06) month utility bills

Father

Yes No N/A

Electricity

Yes No N/A

Mother

Yes No N/A

Gas

Yes No N/A

Guardian

Yes No N/A

Telephone

Yes No N/A

Water

Yes No N/A

Income Tax Certificate

Father

Yes No N/A

Attested copy of rent agreement (if

applicable)

Yes No N/A

Mother

Yes No N/A

Copies of last & latest fee receipts of self and

siblings

Yes No N/A

Guardian

Yes No N/A

Copies of Medical bills/ expenditure related

documents (if applicable)

Yes No N/A

Copies of previous scholarship(s) attained (if

applicable)

Yes No N/A

Yes No N/A

Copy of last Income Tax Return of

Father

Yes No N/A

Statement of Purpose & passport size

Photographs

Mother

Yes No N/A

Salary Certificate of

Guardian

Yes No N/A

Father/ Guardian

Yes No N/A

Picture of House

Yes No N/A

Mother

Yes No N/A

Yes No

Application Case Review Dates

For Official Use

Application Form Complete with
supporting documents
The notices furnished to the
applicant for furnishing of
required documentation

Signature of The Focal person

Date

Page | 9