CIIT/FSPs-I
Cancellation of admission.
Page 1 of 7
CIIT/FSPs-I
Tick the
relevant
Description
Copies of computerized CNIC of
Father
Mother
Guardian
Salary/Income Certificate of
Father
Mother
Guardian
Male
Female
Registration No:
Name of the Department:____________________________________________________________
Degree Title / Program: _____________________________________________________________
Applicant CNIC No:
Marital Status
Age : _________
Single
Married
Divorced
Page 2 of 7
Yes
CIIT/FSPs-I
No
If answer is Yes
Designation: _______________
Mobile: ___________________________________
Email: ___________________________________________________________________
Brothers/Sisters/Children/Family Members studying _____________________________
Details of Siblings Studying
S#
Name
Fee per
month
1
2
3
4
5
6
Total Fees
Fathers Name: _________________ Computerized N.I.C. No ________________________
Status: Alive
Professional status:
Deceased
Employed
Retired
Business Owner
Page 3 of 7
CIIT/FSPs-I
Name
Relationship
occupation ***
Organization
Name
Monthly
Designation
Gross
Remarks
Pay/Earning
1
2
3
4
Property Rent
Land Lease
Bank Deposits*
Shares / Securities*
Other (Specify)
Total
Mother
Spouse
(A)
Self
Other
Total
(B)
* For sources with annual income returns, kindly report the monthly income earned
Total Family Monthly Income
Grand Total Monthly Income of the Family (A) + (B)
Education
Accommodation
Utilities
Food
Medical
Misc.
Total Monthly
Total Annual
Expenditure
Expenditure
Expenditure
Expenditure
Expenditure
Expenditure
Expenditure
Expenditure
Page 4 of 7
CIIT/FSPs-I
No
Transport Type
Make /Model
1
2
3
4
* Others: include tractor, rickshaw, bi-cycle, motorcycle rickshaw, carriage pick, truck etc.
Detailed of Property
Assets Title
Qty
Size
Location (Address)
Residential
Commercial
Agricultural
Employer/
Govt
Scheme
Funds Availability for Applicant Education (per annum in Rupees)
S#
Income Source
Father
Mother
Spouse
1
Salary / Earnings
Self
Other
Total
& Loan *
3
Bank Loan
Other (Specify)
Total
Page 5 of 7
CIIT/FSPs-I
No
(If yes fill the details of scholarships & attach documentary proof of the scholarships)
S#
Name of Institute
Scholarship
Name
Total
Scholarship
Amount
Total
Scholarship
Period
1
2
3
Statement of Purpose (Explain your suitability for this scholarship) - attach separate sheet if required
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
59. UNDERTAKING
1.
The information given in this application is 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.
COMSATS Institute of Information Technology reserves the right to use information given in this form for verification
and other purposes.
Date:
Date:
Page 6 of 7
Yes
No
Document
Submission Date
Remarks
1
2
3
4
Application Case Review Dates (i) _________________(ii) _________________________________
Recommendations of the FSPC
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
It is hereby recommended that Mr/Ms.-------------------------------------------------S/D of -----------------------RollNo.----------------------------Semester---------------------------granted an amount of Rs.--------------- as Qarz-eHasna for---------------------semester ------------------, is recommended after verification of the given information.
---------------------------Convenor of FSPC
Date:----------------------