KPK-Educational Testing and Evaluation Agency (ETEA)

APPLICATION FORM FOR AWARD OF SCHOLARSHIP AND ADMISSION TO CENTRES OF EXCELLENCE FOR THE POOR & DESERVING CANDIDATES

NOTE: No application Form will be accepted at ETEA Office.

(To be filled in by ETEA)

1. Name of student____________________________________________________ (Use Capital Letters)

2. Fathers Name______________________________________________________ 3. Domicile______________________________________ 4. Date of Birth (in figures) ______/______/_________ (01/04/2001 01/04/2003) (in words) _____________________________________________ 5. Educational Institution last attended____________________________________ 6. Class in which studying______________________________________________ 7. Desired institution: (Please indicate the corresponding NUMBER of any

institution, given in the advertisement, in order of preference):

i. __________ ii. ___________ iii.__________ iv. ___________

v. __________ vi. __________ vii. __________ viii. ___________

8. Permanent Address__________________________________________________

_______________________________________(Phone)____________________

9. Present Address____________________________________________________

_______________________________________(Phone)____________________

10. i) Certified that the applicant has been studying in Government School at least for the last one year.

ii) Entries in columns 4-6 (without any cutting/overwriting) verified:

Name of the Principal _________________________ Signature: ___________ (with office seal)

Name of the EDO E&SE _______________________ Signature: ___________ (with office seal)

11. Undertaking by the Candidate and his/her Parent I____________________________S/D/O _______________________________

do certify that I have personally filled out this form and the information is correct to the

best of my knowledge and belief. If the information is found incorrect, the award of

scholarship/Admission may be cancelled at any stage after selection and amount incurred

will be recovered from my parents through District Administration.

Signature of Student ______________ Signature of Parent ________________

- -

Paste one Recent

Photograph without

Attestation Here

Roll Number:

CNIC No. of Father/ Guardian:

S. No: ___________

Clip/Staple Two Recent Photographs

Attested Backside

Here

Gender: Male Female