Professional Documents
Culture Documents
Please
Attach Your
Recent Passport
Size Photograph
PERSONAL INFORMATION
Name:
Surname:
Fathers/Guardians Occupation
Fathers Name:
Date of Birth
Gender:
Place of Birth
Male
Female
Blood Group:
Marital Status:
Religion:
Country of Birth
Single
Married
Nationality:
NATIONAL IDENTIFICATION
Regular Pakistani
Foreigner
Overseas Pakistani
CNIC #:
Date of Issue:
dd
yy
mm
Place of Issue:
Passport No.
Place of Issue
Date of Expiry
CORRESPONDENCE ADDRESS
__________________________________
__________________________________
__________________________________
City:
Province:
Cell #:
Email:
Tel #:
TEST CENTRE
Please indicate your preferred Admission Test Centre.
Hyderabad
Karachi
Sukkur
Multan
Islamabad
CAMPUSES
Please indicate your preferred campus for admission.
Hyderabad
Karachi
Islamabad
Postgraduate
You have three choices. Please select the program of your choice by inserting 1, 2 and 3, in
the box adjacent to the program, indicating your first, second and third choice, respectively.
BS (Telecommunication)
MBBS
BS (Electronics)
BDS
Associate of Applied Science (SE, ES, TC)
DPT
B.Tech _______________________ Hons
BS (Nursing)
Pass
BBA
Diploma in Health Care Assistance (DHCA)
Associate of Applied Science (Business Administration)
BE (Electrical)
BS (Commerce)
BS (Computer Science)
BS (Economics)
BS (Information & Communication Technology)
BS (Software Engineering)
MS (Master of Science)
MBA
Master of Public Health
M. Phil
M. Phil~PhD
PhD
MD
MS (Master of Surgery)
Diploma
MDS
M.Sc (Dental)
FCPS (Residency Program)
MCPS (Residency Program)
Field of Specialization:
Note: For fields of specialization, please refer to pages 164 & 165 of the prospectus.
Undergraduate
You have three choices. Please select the program of your choice by inserting 1, 2 and 3, in
the box adjacent to the program, indicating your first, second and third choice, respectively.
MBBS
BS (Vision Sciences)
DPT
Postgraduate
KARACHI CAMPUS
PPDPT
MS (Master of Science)
M. Phil
Field of Specialization:
MD
MS (Master of Surgery)
PGD
Undergraduate
Postgraduate
Undergraduate
HYDERABAD CAMPUS
ISLAMABAD CAMPUS
You have three choices. Please select the program of your choice by inserting 1, 2 and 3, in
the box adjacent to the program, indicating your first, second and third choice, respectively.
MBBS
BS (Audiology)
BS (Electronics)
DPT
B.Sc (Medical Technology)
BS (ICT)
BBA
BS (Vision Sciences)
B.Tech (Hons)_____________________
BE (Electrical)
BS (Physiology)
Associate of Applied Sciences (ES, SE, TC, BA)
BS (Computer Science)
BS (SLT)
PhD
MS (Master of Science)
MBA
PGD
M.Sc
PPDPT
Field of Specialization:
Note: For fields of specialization, please refer to page 160 of the prospectus.
M. Phil
PhD
MS (Master of Surgery)
City
Date (Year)
From
To
Year of Completion:
Marks obtained
Subjects
Marks obtained
Year of Completion:
Name of Degree:
Major Subject(s):
Marks Percentage:
CGPA/Division:
Year of Completion:
Name of Degree:
Major Subject(s):
Marks Percentage:
CGPA/Division:
DECLARATION
The statements I have made above are true. I agree to conform to the discipline of the selection process and to accept the decision
of Isra University concerning the evaluation of my application and the final selection. I have read the prospectus and fully
understand all the information provided therein; and agree to abide by all the instructions and directions, as well as matters
pertaining to payment of fees including fine charges on late payment of fees, issued from time to time by the University.
Date
Applicants Signature
I hereby testify that the statements made by my ward are correct to the best of my knowledge.
I also affirm to ensure that all the commitments made by my ward are fulfilled.
Name of Parent
CNIC:
Guardian
Signature
NTN:
Date
Note:
No documents will be returned or their copies supplied. Please keep copies of all the documents for
your record.
Correspondence will be done by courier service on the notified address. The University shall not be
responsible for non-delivery of any correspondence due to the negligence of the courier service or
unnotified change of address by the applicant.
NEWS SOURCE
Internet
Electronic Media
Other________________
Friends/Relatives
Islamabad Campus:
Admissions Office, Al Nafees Medical College & Hospital
Lethrar Road, Frash Town, Phase - II, Islamabad, Pakistan.
Tel: (+92 51) 8439901-10 Fax: (+92 51) 8439900
URL: http://www.isra.edu.pk Email: alnafees@isra.edu.pk