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PrimeMinistersNationalICTScholarshipProgram2013

School/CollegeRegistrationForm
Pleasecorrectlytick()thepurposebeforefillingthisform.

RequestforSchool/Collegeregistration
Modificationinalreadyregisteredschool/college

(Incaseofmodification,pleaseprovidepreviously
registeredschool/collegecodehere_____________)

FillthefollowingforminCAPITALletters.

1. NameofSchool/College:
2. BoardAffiliation:
3. PostalAddress:

City/Town:

Tehsil:

District:

Province:

4. Telephone#:

5. Fax#:

6. PrincipalsName:

Mobile#:

7. AlternateContactPerson:

Mobile#:

8. EmailAddress:

9.NumberofstudentscurrentlystudyinginyourSchool/Collegeunderthefollowingdisciplines:
PreEngineering
(Maths,Physics,Chemistry)

ICS
(Maths,Physics,ComputerSc.)

GeneralScience
(withMaths&Physics)

10. TuitionFee:
Rs.permonth/students
(TuitionFeeisnotrequiredfromGovernmentSchools/Colleges.TuitionfeeisrequiredonlyIfyou

school/Collegeisprivate/semiGovernmentandlocatedinAzadJammu&Kashmir(AJ&K),GilgitBaltistan
(GB),FederallyAdministeredTribalArea(FATA)orBalochistan.)

PrincipalsStamp&Signature
ForofficialuseofNationalICTR&DFund:
CodeIssued:______________________Issuedby:_______________________
NationalICTR&DFund
6 Floor,HBLTower,JinnahAvenue,Islamabad|Tel:051921536065,Fax:0519215366
th

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