Lahore University of Management Science Application form for National Outreach Programme Batch 2013 Who can apply? 1 Photograph Paste here with glue Applicants should have atleast 80% MARKS IN MATRICULATION in order to apply for the NOP. Moreover, NOP is a NEED BASED SCHOLARSHIP. Only genuinely financially deserving students will be considered for the Programme. Instructions for the submission of application form: Please follow these instructions carefully: • • • • • Fill the form in BLOCK LETTERS.

Fill in the form using a black pen. Write your name and date of birth at the back of each photograph. Fill the form completely; INCOMPLETE forms will not be processed. Submit all the required supporting documents (Listed below) with your application form. Applications WITHOUT COMPLETE DOCUMENTS will not be processed. No further reminder will be sent. • • Application Form along with all the required supporting documents should reach LUMS Admissions Office latest by April 19, 2013.

Selection decisions will be mailed in June – July 2013. CHECKLIST OF THE REQUIRED ACADEMIC DOCUMENTS: Please mail all the required supporting documents (mentioned below) along with the application form in a single envelope to the mailing address given below in the box: • • • Three attested latest passport size photographs; Attested copy of Matriculation/O level result card (Attestation should be from your School); Attested copy of National Identity Card (NIC) of your parents/guardian;

Page 1 of 9 CHECKLIST OF THE REQUIRED FINANCIAL AID DOCUMENTS: For each of the items in the check list below, please ensure that you either provide the relevant document(s) or if this is not possible specify a logical reason for not being able to do so. For example: If you don’t have any loan outstanding against your name, you can write: I certify that I don’t have any loan outstanding against my name. The LUMS Financial Aid Office has the right to accept or reject the explanation/reason. • • •

Income certificates of all earning members of the family* – This includes latest salary slip for salaried persons (father/ mother/ brothers/ sisters), pension books for retired, income affidavit for self employed or businessman and a certificate/ proof in case of any other income. Bank Statements (for the last year) of all bank accounts in the names of all the family members and in the name of business in case of businessmen. Utility Bills (last three months) – Electricity, Gas, Phone, Water. Note: * An income certificate is the document that shows monthly/annual income.

If your parents/guardian are salaried, an original copy of a pay slip should be attached, otherwise if your parents/guardian own a business they should submit Bank Statement for the last one year. If parents/ guardian do not fall in either of the above two cases (that is salaried employee or business man) they should submit an undertaking on a stamp paper/affidavit (of Rs. 20) stating their income and with relevant details. Important Notes: • • In case of providing false information, candidate will be disqualified and his / her application will not be considered.

If required, you will be requested to provide more financial documents/ information to carry the process further. Mailing address is given below: Syed Absar Ul Hassan Office of Admissions Lahore University of Management Sciences Sector U, DHA, Lahore Cantt. 54792 2 Photographs Staple here Page 2 of 9 Personal Information Name: Father’s Name: Guardian’s Name: Date of Birth (of student): ______/______/______ dd / mm / yy Father’s / Guardian’s NIC #: (Provide a copy of NIC) Mailing Address: (All future correspondence will be made on this address) CITY: Phone #: / (City code) DISTRICT: Mobile #: PROVINCE:

Permanent Address: ( If different from the mailing address) CITY: Phone #: / (City code) DISTRICT: PROVINCE: Email*: * It is mandatory for you to have a valid email address as well otherwise your form can be considered INCOMPLETE. Do you have internet access at home or near your house? YES NO Page 3 of 9 Secondary School Information Total Marks/ Grades Matric / O-level Name of School / College Name of Examination Board Did you have a position in Board Exam? If yes; which one? YES NO Obtained Marks/Grades 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 Post Secondary School/Intermediate level Degree Information

Have you completed your intermediate level degree? YES NO Total Marks/ Grades Intermediate / A-level 1st year Intermediate / A-level 2nd year General Science Roll No: Obtained Marks/Grades Stream Name: Pre-Medical Pre-Engineering Arts/Commerce Other Name of Examination Board Did you have a position in Board Exam? YES NO If yes; which one? Any other achievement: 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 Give details of teacher / headmaster / principal of your institution who knows you personally. Name: School: Tel:________/_____________ (city code) Address:__________________________________________

Email address: Page 4 of 9 Give details about yourself and your siblings*: *Siblings are brothers and sisters Full Name Age (in years) School / College / University (If still studying) Annual Fee (in Rs) Parents Scholarships Contribution (in Rs) (in Rs) Assets Title i. House ii. Land / Plot iii. Agriculture iv. Commercial Any other information Asset Ownership** Current Value ( in Pakistani Rupees) Area (in Kanals/Marlas or Sq. Feet) Location **In this column provide information about who owns the specific asset. It can be your father, mother, brother or grandfather etc.

Income Source Profession i. Agricultural income (Annual) ii. Salary / Pension (Annual) iii. Returns on Saving & Investment (Annual) iv. Rental Income(Annual) v. Business Income (Annual) vi. Income from any other source Total (i, ii, iii, iv,v & vi) A: Total Income: (A+B+C) Father’s Mother’s Guardian’s / Brother’s & Sister’s B: C: Page 5 of 9 How many air-conditioners do you have in your house? Type of Vehicle 1 2 3 4 Make and Model Owned by Annual Educational Expenses Annual Rent (If living in a rented house) Annual Taxes Annual Telephone Bills Are there any outstanding loans? ) ii) iii) Yes No Annual Medical Expenses Transportation/Food/Traveling Expenses/Other Expenses (per Annum) Annual Electricity Bills Annual Water/Gas Bills If yes then: Please indicate the amount of loan in Rs. ________________________. And also please specify the purpose for taking the loan ___________________ The source from where loan was taken Bank * Relative Employer* Other (Please Specify): * Please attach the supporting documents in case the loan is taken from a Bank or Employer. Any other expense: ? Tuition Fee for the first year at LUMS is Rs. 5,00,000/- approximately ?

Please Indicate the total amount of contribution you can make towards your tuition fee annually at LUMS Rs: ________________ Page 6 of 9 Why do you require financial aid (Attach separate sheet if required)? How did you get to know about National Outreach Program? (Tick any one of the following) Friends/Relatives Newspaper Add LUMS website Information Session at School/College Kindly mention the School/College Name where you attended the session:_________________________________________ Other(Please Specify): ___________________________ Undertaking: I certify that the information given on this form is accurate to the best of my knowledge.

I understand that any misrepresentation may cause my dismissal from the Programme at any stage. ________________________ Applicant’s Signatures Date: ______/______/______ dd / mm / yy ________________________ Father/Guardian’s Signature Date: ______/______/______ dd / mm / yy For enquiries regarding your application form contact us at: Phone: 042-35608000; Ext: 2433 Fax: 042-35898317, Email: helpdeskao@lums. edu. pk Page 7 of 9 Essay Topic: Describe a situation or an experience of your life which demonstrates your best characteristic or quality (200 words): You can express your ideas in English or Urdu. Page 8 of 9 Page 9 of 9