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Application Form 2023-24

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KHAIRPUR NEED CUM- MERIT SCHOLARSHIP 2023-24

APPLICATION FORM
Passport size photo

PART-1

1. Name 2. Father’s /Guardian’s Name

3. Caste Male Female 4.C.N.I.C No. --

5. Date of Birth 6. Taluka /Tehsil 7. Mobile No.


(DD) (MM) (YYYY)

8. Domicile/PRC (a) Student (b). Father / Guardian

9. .Father’s / Guardian’s Occupation 10. Religion

11. Parents / Guardians Monthly Income


(SALARY SLIP/INCOME CERTIFICATE ATTACHED)

12. Name of the Institution

13. Semester/Year/Date of Admission

14. Name of Degree/Duration of Course

15. Studying whether on: please tick mark() (a). Merit Basis (b). Self-Financing Basis

16. Permanent Address

17. Present Postal Address

18. Last Examination Passed: Year Total Marks Mark s Obtained %age
(An Original Mark sheet must be attached)

19. Bank Account No. with area code and name of Bank Branch
(With city name) (only students account detail acceptable)

Certifiedthat information provided by me is true& correct ifanything proved to be false at any stage, then my
application shall be liable to be rejected.

Date: Signature of Student

1
PART-II
CERTIFICATE FROM THE HEAD OF INSTITUTION / DEPARTMENT (Mandatory Requirement)

This is to certify that Mr. /Ms._____________________________________________________


S/O, D/O ________________________________ is a bonafide student of _________________________Year
under class Roll No. ___________.He/She is studyingin ______________at this Institute /College /
University. His / her conduct is satisfactory, facing financial hardships to continue his/her education.
Therefore, his/her case is recommended for consideration to District Scholarship Board Khairpur, Sindh.

Signature and Stamp


Head of the Department/College /Institution

Very Important: The Enrollment of the student & documents are verified by the Head of Department / institute

PLEASE TICK MARK REQUIRED DOCUMENTS ()


 The candidates will have to produce certificate from the Head of Department of concerned college/Institute/University
on prescribed application form of 2023-24 showing the enrollment in the respective College/Institute/University.
 Original Marks Certificate of last examination passed (2022 and onwards)
 Student’s personal bank account statement / cheque leaf
 Attested copy of Domicile and PRC of Student and his father/Guardian
 CNIC of student (if under age, B-Form of NADRA must be attached) and his/her father/guardian.
 Attested Copy of Student ID Card
 Attested Copy of Pass Certificate of Matriculation showing Date of Birth issued by the concerned Board.
 Father/ Guardian’s Income Certificate. In case, father/guardian are government employee, his last month pay slip may
be attached.
 One fresh passport size photograph.
 All Attached Documents Must be Attested from Gazetted Officer

MOST IMPORTANT
 This form & criteria can be downloaded from Facebook page of “Khairpur Poverty Cum Merit Scholarship
Board (https://www.facebook.com/kncmsb)
 All the students (Male / Female) are strictly directed to please submit application forms through their
respective / concerned institutions / Degree College / Universities where they are pursuing their study and
after having been scrutinized, the heads of the institutions / Degree College / Universitiesare requested to
please forward the eligible cases onlyas per criteria with covering letter to the Scholarship Branchestablished
AT OFFICE OF THE DEPUTY COMMISSIONER OFFICE / CHAIRMAN DISTRICT SCHOLARSHIP BOARD
KHAIRPURfor further process.
For Office Use Only
Application of the Student accepted Scholarship Amount Sanctioned Rs:

Application of Candidate Rejected


Reasons of Rejection

Name and Signature of the Authorized Person __________________________________________________

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