Registration No.

Filled by NTS

REGISTRATION FORM

NTS

Ministry of Inter Provincial Coordination (IPC Division)

MBBS/ BDS Courses In Bangladesh Academic Year 2014
A keyword (only 4 Digits) provided by the candidate to submit correction query later for correction in provisional candidate list on the NTS website

2 Picture Paste your recent passport size color photograph with Stapler

*. Authentication Keyword

Bank Online Deposit of Rs: 800/- from Designated Bank Branches.

Bank Name & Code Deposit Date
*Note: Application Form will not be entertained without Original Deposit Slip (NTS Copy) having Bank Stamp on slip.

2. Desired Test City

1. 2. Islamabad Lahore

Fill Only One Box for Desired Test City (Mandatory) (Subject to a minimum of 200 candidates, other wise the candidates will be assigned next nearest test city)

3. 4.

Karachi Peshawar

5. 6.

Quetta Multan

7.

Faisalabad

Personal Information:
3. Name in Full: 4. Fathers Name: 5. Candidate CNIC# :

Use CAPITAL letters and leave spaces between words.

Mandatory (write your own CNIC No also attached the photocopy of your CNIC. Other wise you are not Eligible )

6. Gender:

Male

Female

7. Date of Birth:

Write your Correct Date of Birth other wise you will be rejected

1 9

8. Email:

9. Postal Address:
(All correspondence will be made on this address)

City: 10. Phone No:

(OFF.) (RES.)

Postal City District:

(Mobile)

(City Code - Phone No)

11. Place of Birth: 12. Pasport No: 13. Name of guardian: 14. Address of guardian:

Country of Birth: Date of Issue:

Nationality: Any other travel document: Nationality:

15. Name & Address of person to be notified in case of emergency: (A). In Bangladesh: (B). In Country of Domicile: 16. Have you applied for admission in any educational institute in Bangladesh: Yes No MBBS
If yes, give year & decision, if any communicated to you

17. Name of the course to which admission is sought:

Note Candidate who desires to be considered for more than one course should submit separate application for each course

BDS

18. Domicile Fill Only One Box for Desired Domicile

1. 2. 3. Punjab Khyber Pukhtoonkhwa Balochistan 4. 5.

(Mandatory)

Sindh Urban Sindh Rural

6. 7.

AJK Fata Fana

19. Academic Information:

Certificate / Degree Level Degree Name

(Please attached your required document)

Year Passing Obtained Marks/CGPA Total Marks/CGPA

Note: 1. NTS will not issue Roll No Slips to those who have not given their academic record accordingly.
Major Subject Institute/Board

SSC/ O-Level
(10 Years Degree)

HSSC/ A-Level
(12 Years Degree)

20. Proficiency of Language:

Language
Reading Excellent Good Fair Excellent Writing Good Fair Excellent Speaking Good Fair

21. Cross check of basic criteria:

A. I have secured more than 65% marks in SSC & HSSC or equivalent exam? B. I have passed my SSC or equivalent exam not before year 2009? Yes Yes No No

Undertaking By The Applicant:

I_____________________________ d/s/w of _________________________do hereby solemnly affirm that I have read and understood the conditions for appearing in the NTS Test and that I have filled the form as per instructions given above and in the event any information contained herein is found to be untrue, I shall be liable to disciplinary action which may result in cancellation of my test. Date: ________________
Attach your recent Photograph, CNIC copy and Original Bank Deposit Slip NTS Copy. By Hand submission of Application Form is not allowed. Mobile Phones are not allowed in Test Center premises. Application should reach NTS office latest by last date of submission of Application Form. NTS will not be responsible for late receiving of application through courier / Pakistan Post etc. Applications received on 12th September 2013 will not be entertained by NTS

Signature of the Candidate:__________________

Help line:
Phone No. ISB: 051-9258478-79 LHR: 042-99239258 KHI: 021-35215013 PES: 091-9218233 Website: www.nts.org.pk E-mail info@nts.org.pk

Send Application Forms to:

Schedule of Test
Sunday, 29th September 2013 11th September 2013

Test Date: Last Date of submission Application form:

Manager Operations National Testing Service 96, Street No. 4, Sector H-8/1, Islamabad.

NTS
Branch Code: Branch Name:

National Testing Service

Building Standards in Educational and Professional Testing

NTS
Branch Code: Branch Name:

National Testing Service

Building Standards in Educational and Professional Testing

Date:

Date:

ONLINE DEPOSIT SLIP

(* Please deposit fee in only one bank & tick the relevant bank)

Allied Bank Limited

(Formely: Allied Bank of Pakistan Limited)

Muslim Commercial Bank

0041749181000999 Note: Bank Service Charges Free of Cost
NTS-Collection
LTD THE POWER TO LEAD

Allied Bank Limited

(Formely: Allied Bank of Pakistan Limited)

Muslim Commercial Bank

A/C 0041749181000999 No. Note: Bank Service Charges Free of Cost Remote Branch: A/C Title:

Remote I-8 Markaz Branch Islamabad (0140947) Branch: A/C A/C Title: NTS-Pakistan-Collection No. 0010008325640018

Remote Branch: A/C Title:

I-8 Markaz Branch, Islamabad (1501)

A/C No.

Remote I-8 Markaz Branch Islamabad (0140947) Branch: A/C A/C Title: NTS-Pakistan-Collection No. 0010008325640018

I-8 Markaz Branch, Islamabad (1501)

NTS-Collection

Note: Bank Service Charges Free of Cost

Note: Bank Service Charges Free of Cost

LTD THE POWER TO LEAD

Remote Branch: A/C Title:

Cantt Br Kashmir Road Rawalpindi (0041) NTS- Pakistan

A/C No.

0205523391

Remote H9 Shalimar Recording Co ISB (1742) Branch: A/C A/C No. 1742-79002786-03 Title: NTS-Collection

Remote Branch: A/C Title:

Cantt Br Kashmir Road Rawalpindi (0041) NTS- Pakistan

A/C No.

0205523391

Remote H9 Shalimar Recording Co ISB (1742) Branch: A/C A/C No. 1742-79002786-03 Title: NTS-Collection

Note: Bank Service Charges Free of Cost

Note: Bank Service Charges Free of Cost

Note: Bank Service Charges Free of Cost

Note: Bank Service Charges Free of Cost

*Note: Desired Bank Stamp is required on the Deposit Slip & Send Original Deposit Slip (NTS Copy) along Application Form to NTS Office a Application Form will not be entertained without Original Deposit Slip (NTS Copy)
Applicants Name: Father Name: CNIC No/ B Form No: Amount Rs:

*Note: 1. Please Stamp both copies of deposit Slip. 2. The Bank Must Return NTS Copy to the Candidate. 3. Deposit Slip will not accepted without Candidate CNIC/ B Form No.
Applicants Name: Father Name: CNIC No/ B Form No:

800/-

Amount in word: Rs.

Eight Hundred Rupees Only.

Non Refundable/ Non Transferable

Amount Rs:

800/-

Amount in word: Rs.

Eight Hundred Rupees Only.

Non Refundable/ Non Transferable

Applicant Signature

Cashier

Officer

Applicant Signature

Cashier

Officer