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(FOR OFFICE USE ONLY)

JINNAH MEDICAL & DENTAL COLLEGE 

Application fo A!"i##ion to

M$$S $DS

1st Preference2nd Preference

FOR OFFICE USE ONLY A%TITUDE TEST

HSC (Science / English)________________ % English_____________  '

 HSC Mark Sheet___________________% Biology_____________  

  !e"els Mark Sheet _______________% Che#istry___________   **********+  

$ther Mark Sheet_______________P Physics______________  

  E&'i"alency ___________________% Math_______  , *_______ ,

 Matric Mark Sheet__________________% TOTAL  __________ (__________%)

 $ !e"els Mark Sheet________________% MERIT -  _________ (__________%)

Category  %NRA FOREIGN LOCAL  

d#it Card +ecei"ed, 

 _______________________ 

  Signat're of the +eci-ient . ate

 Paste Passport 

Size Photo taken

Within Last Six Weeks

 a#e_____________________________________________________________ 

ate of Birth__________________________ ge_____________

 ationality____________________ o#icile____________________________ 

--licant0s *C o_______________________________________________ 

--licant0s Pass-ort o______________________________________________ 

Place of Birth______________________________________________________ 

  Countr 

Fat./0# G1a!ian0# Info"ation

 a#e_______________________________________ 

ge________ Ed'cation________________________ 

Present $cc'-ation____________________________ 

 a#e of E#-loyer____________________________ 

Monthly *nco#e______________________________ 

C*C o__________________________________ 

Mot./0# Info"ation

 a#e_______________________________________ 

ge________ Ed'cation_______________________ 

Present $cc'-ation____________________________ 

 a#e of E#-loyer____________________________ 

Monthly *nco#e______________________________ 

C*C o_________________________________ 

Si2lin3 Info"ation

 ME E EC*$

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EDUCATIONAL INFORMATION

 a#es and ddresses of all ed'cational instit'tions attended ES EE

3ro# o rade %Score

Hi3. Sc.ool Coll/3/

 a#e ____________________________________________ 

ddress __________________________________________ 

 _________________________________________________ 

 _______ ________ 

S/con!a4 Sc.ool

 a#e ____________________________________________ 

ddress __________________________________________ 

 _________________________________________________ 

 _______ ________ 

%i"a4 Sc.ool

 a#e ____________________________________________ 

ddress __________________________________________ 

 _________________________________________________ 

 _______ ________ 

A!!/## fo Co/#pon!/nc/

(Please notify change of address immediately)

Fat./0# G1a!ian0# $1#in/## A!!/##5

ele-hone ________________________________ 

--licant Mo4ile________________________ 

E5Mail ddress ____________________________ 

B'siness ele-hone ______________________ 

Ho#e ele-hone ________________________ 

3a6 ________________________________ 

E6TRA7CURRICULAR ACTI8ITIES AND OTHER EDUCATIONAL ACHIE8EMENTS5

%ERSONAL STATEMENT5 Briefly descri4e yo'rself and yo'r goals in 178 9ords or less on a se-arate

Sheet the sa#e si:e as the a--lication for#; and attach to the a--lication

T./ #tat/"/nt# I .a9/ "a!/ a2o9/ a/ t1/: I a3// to confo" to t./ !i#ciplin/ of t./ #/l/ction poc/## an! to

acc/pt a# final t./ !/ci#ion# of t./ Coll/3/ S/l/ction $oa!:

 

 _______________ _______________________________ ___________________ 

  ate Parent

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INSTRUCTIONS

1. Read the Prospectus and the instructions carefully before completing the application form.

2. The minimum requirement to apply for any JMDC program M!!"# !D" and Pharm$D% is&'( mar)s in the *igher "econdary Certificate pre$medical +,amination *"C% of thePa)istan !oards of +ducation or its equi-alent determined by the !CC% nterboardCommittee of Chairmen.

/. Please type or print in bloc) letters.

0. The application should include

a. To color passport si3e photographs ta)en ithin the last & ee)s ith your nameon the bac). 4ne should be pasted to the application form and the other to the+ntrance +,am 5dmit Card.

b. Attested photocopies of the following documents must be submitted with theapplication:

*"C Mar)sheet or 465 7e-el Mar)sheets# *igh "chool Transcript%

!CC +qui-alence Certificate for *"C for non Pa)istani !oard graduates%

""C Mar)sheet

""C Certificate

!CC +qui-alence Certificate for ""C for non Pa)istani !oard graduates% 8ational D Card or ! form ith 9ather:s D Card%

Passport for 8on Pa)istani 8ationals%

Certificates of academic and e,tra$curricular achie-ements after ; Class.

Personal "tatement 1