UET MESS SCHOLARSHIP

APPLICATION FORM
Scholarship is based on assessment of need 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).

PROVIDING FALSE INFORMATION

Providing false information may result in one or all of the following:

• Disqualification for award of any future loan/scholarship.

• Refund of all the payment received and or a penalty equal to total scholarship amount.

INSTRUCTIONS FOR FILLING OUT THE SCHOLARSHIP APPLICATION FORM:

✓ Fill in the form using blue/black ball point pen and write in capital letters
✓ Read the application form carefully.
✓ Make sure everything is correct and final
✓ Submit duly completed application form to the respective munshi/RT of the hostel.
✓ Furnish factual, comprehensive and authentic information in the form
✓ For family financial reporting parents/guardian may be consulted for guidance
✓ Ensure that you have attached all the required documents by putting a tick mark in checklist
✓ Answer all questions. Those not applicable should be marked “N/A”
✓ Affidavit Needs to be submitted after final selection of the candidate
 Application Form Check List
SN Description Tick the
relevant
1 Copies of computerized NIC of
Father
Mother
Guardian

2 Salary Certificate of
Father
Mother
Guardian

3 Copies of last month utility bills

Electricity
Gas
Telephone
Water

4 Copies of last & latest fee receipts of self and siblings *

5 Copies of pervious scholarship(s) attained (if applicable)
*Tick the Section When Completed

I Section A: Personal and family information

II Section B: Cumulative information of Self, Parents & Guardian Assets
III Section C: Financial arrangements for current year
IV Section D: Educational Record
DO’s:
• submit your printed application by hand to the respective munshis/RTS of hostel.
• Put all amounts in Pak Rs.
• Writing email and phone number is compulsory in form.
• Do consult with parent(s)/guardian(s) for financial data accuracy & reliability
• For the information not present/relevant write in capital letters N/A
DO NOT:
• Provide False/vague/ incomplete information.
• Overwrite/ scratch on the form.
 UET Lahore Mess Scholarship Program Page 1 of 6

Name of the Hostel/Room no.:

Department/Registration number:
1. Applicant’s Name: Gender: Male Female
2. Applicant NADRA - -
NIC No.
3. Marital Status Single Married Divorced
4. Age : Domicile
5. Present Address
6. Permanent Address:
7. Are you currently working : Yes No
8. If answer is Yes to Section No. 8 complete the sections (9-13)
Designation: Name of Employer /Company:
9. Total Monthly Applicant Gross Income in Pak Rs.
10. Total Monthly Applicant Take Home Income* in Pak Rs.
* Take Home Income: Salary / Pay available after deduction of taxes, provident fund charges etc.
11. Tel (Res.): Mobile: Email:
12. Total Family Members currently living with you:
S# Name of Family Member (s) Relationship Marital Status Remarks**
1
2
3
4
5
6
13. Details of Family Members Earning (Take extra sheet if required):
Family Member Monthly
S Family Organization
Relationship occupation Designation Gross Remarks
# Member Name Name
(Specify) Pay/Earning
1
2
3
4
14 Total Monthly Family Income (add self income, if applicable) Pak Rupees
 UET Lahore Mess Scholarship Program Page 2 of 6

15. Brothers/Sisters/Children/Family Members studying

Relation
S# Name with Name & Address of Institute Fee per month
applicant
1
2
3
4
5
6
15A Total Fees & Tuition Charges

16. Father’s Name: Computerized N.I.C. No

17. Status: Alive Deceased
18. Professional status: Employed Retired Business Owner
19. Name of Company/Employer:
20. Tel (Off): Mobile:
21. Occupation Type: NTN
22. Designation & Grade ( BPS/ SPS/PTC etc): Gross Monthly Income:
23. Total Net Monthly Take Home Income (Salary/ Pension/ Others):
24.Any Other Supporting Person (Mother/ Guardian/ Brother/ Sister/Family Relative/Guardian):
25. Name: Relationship:
26. Occupation and Designation
27. Monthly Financial Support Available to Applicant in Pak Rs.
28. Asset Income (on monthly basis)
S# Income Source Father Mother Spouse Self Other Total
1 Property Rent
2 Land Lease
3 Bank Deposits*
4 Shares / Securities*
5 Other (Specify)

28A Total
 UET Lahore Mess Scholarship Program Page 3 of 6

29. Total Family Monthly Income

Monthly Income Monthly Gross Monthly Net
S# Family Member Name Relationship from Assets Pay/Earning (Take home)
Pay/Earning
1

5 Applicant Monthly Gross Pay/Earning

6 Applicant Monthly Net (Take home) Pay

29-A Total Monthly Income in Pak Rupees

Total Annual Income in Pak Rupees

29-B

30. FAMILY EXPENDITURES

30A. Accommodation Expenditures
Type: Bungalow Apartment /Flat Town House Village House
Status: Rented Self or Family owned Employer / Govt Owned
Rent Payment: Self Employer/Govt Others
House Plot Size in Sq. ft. Covered Area in Sq. ft.
Number Of
Accommodation Number Of Accommodation Accommodation
S# Air
Location /Address Bed Rooms Monthly Rent Annual Rent
conditioners
1-2 1-2
2-4 2-4
4-6 4-6
Above 6 Above 6

30B Total Accommodation Rental Expenditure

Any other house/flat owned by the Parents/Guardian (if yes please specify with location
and size)
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31. Utilities Expenditures

Last Month Utilities Paid
Telephone Electricity Gas Water

32. Medical Expenditures: Average of last six months (Per Month Expenditure)
Total Family Expenditures
Education Accommodation Utilities Medical Misc. Total Monthly Total Annual
S# Expenditure Expenditure Expenditure Expenditure Expenditure Expenditure Expenditure

33

S# Description Amounts in Pak Rupees

(Sec.29A) Total Monthly Income
(Sec. 33) Total Monthly Expenditure
34
Net Monthly Disposable Income*
(29.A – 33A)

S# Description Amounts in Pak Rupees

(Sec.29B) Total Annual Income
(Sec. 33) Total Annual Expenditure
35
Net Annual Disposable Income*
(29.B – 33.B)

* If the monthly / Annual Disposable Income is negative, kindly explain the reasons for the gap, and
the arrangements through which the differential gap is met by the family

Assets (with current market value)

36. Does the family own any Transport? Yes No
If yes kindly fill the relevant details

Make Ownership
S# Transport Type Engine Capacity (CC) Registration No.
/Model Period
(Car/ Motor cycle/ Others*)
1
2

* Others: include tractor, rickshaw, bi-cycle, motorcycle rickshaw, carriage pick, truck etc.
 UET Lahore Mess Scholarship Program Page 5 of 6

37. Number of Cattle(s) (with kind)

38. Area and location of Land(s)/Plot(s) owned
Cultivable Agricultural
Assets Title Qty Size Location (Address) Area Yield per
Acre
Residential
Commercial

Agricultural
Employer/Govt Scheme
39. Assets worth (Current Market Value in Pak. Rs.)
S# Assets Title Father Mother Spouse Self Guardian Total
1 House
2 Business
3 Land & Building
4 Bank Balance
5 Stocks/Prize bond
6 Others/ Cattle(s)
40. Total
41. Loan taken for Applicant Education
* Family/ Friend Loan
(Specify details of loan taken and relationship with the relative / friend)

42. Any source of financing other than loan (Please specify)

43. How were the admission /first semester charges paid?

44. Applicants educational record:

Name and Location of Session/ Registration. Division/ %age /
Level of Study
Institute Year No. GPA/ CGPA
Bachelors(on
going)
Intermediate
Secondary
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45. Per month fee/ tuition charges of the institution last attended
46. Have you ever got any other Scholarships: Yes No
(If yes fill the details of scholarships & attach documentary proof of the scholarships)

Total Total Class / Level at which

Scholarship Scholarship was
S# Name of Institute Scholarship Scholarship
Name granted
Amount Period
1
2
Statement of Purpose (Explain your suitability for this scholarship) - attach separate sheet if required

UNDERTAKING
1. The information given in this application are 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. UET reserves the right to use information given in this form for verification and other purposes.
Date: Parents / Guardian Signature Applicant Signature:

For Official use only

Are the applicant documents in order? Yes No

Application Case Review Dates (i) (ii)

Additional Remarks

Date Resident tutor Name Signature Resident tutor

& Hostel Name