Chief Minister Education Endowment Fund (CMEEF) Scholarships Application Form for Graduate International Program (PhD/DPhil)

Transcription

1 Chief Minister Education Endowment Fund (CMEEF) Scholarships Application Form for Graduate International Program (PhD/DPhil) Affix attest ed re c e nt ph oto gr a ph Eligibility Have domicile of Khyber Pakhtunkhwa Have age less than 45 years on the closing date Have first-class academic career (minimum first division or CGPA of 3.00/4.00 or 3.75/5 in semester system) Have valid unconditional offer of admission in any of the approved PhD/DPhil degree program in top 100 universities of the world (QS Ranking 2018) Not be in recipient of any other scholarship or financial assistance awarded for the degree program Have minimum 60% score in GRE International (General or Subject) Instruction for Filling out Scholarships Form Download the form, fill it carefully and submit to PMU-HED on or before the closing date. Ensure that you have attached all required documents by completing the checklist. Answer all questions. Those not applicable should be marked N/A. Do not provide false or incomplete information. Provision of false information shall lead to cancellation of scholarship and legal proceedings. Use extra sheet (if required). Check List Affix attested recent photograph Attested copy of CNIC Attested copies of all educational testimonials CV/Resume Copy of valid unconditional offer of admission for PhD/DPhil Copy of Synopsis/ Research Proposal Attested copy of domicile Three passport size photographs (blue back ground) Valid GRE International (General or Subject) certificate NOC from parent department (for employed candidates only) Any other supporting document required to substantiate the facts given in the application form Page 1 of 11

2 1. Personnel information: Full Name: Father Name: Passport No: CNIC No: CNIC No: Passport Expiry Date: Date of Birth: Domicile: Gender: Mailing Address: Permanent Address (if different from above): Contact Nos Mobile 1. Mobile 2. Home: Fax: Office: References in Pakistan: Provide contact details i.e. name, postal address, , relationship with the applicant, phone number of person who can be contacted in Pakistan on your behalf (e.g parent, siblings, spouse etc) Marital Status: Single: Married: If married please specify number of people financially dependent on you Do you have a valid visa to the country of the proposed study: Page 2 of 11

3 2. a) Academic Qualifications: Certificate/Diploma/ Major Result Degree Subjects Declaration Date SSC/Matric Marks Total CGPA Institution Board/University Obtained Marks HSSC/Intermediate Bachelors (B.A,BSc, Hons. etc.) Masters or equivalent M. Phil GRE International (General or Subject) Other (please specify) 2.b) List of scholarships or fellowships held at present or in past (Give source or s ponsor, amount, where held & duration 2.c) Indicate any academic honors/medals or prizes which you have received, with titles and dates 3.a) Offer detail for PhD/DPhil Program: Name of Country Date of Date of University Subject Area Details of Supervisor University Commencement Completion Ref/ID. of Classes Code S Major pecialization Title of Name Contact area PhD/DPhil 3.b) Detail of Courses opted at PhD Level Course Name Date/Semester Course Type Core/Elective Total Credits of Course Page 3 of 11

4 3.b) Preferred Subject Areas (circle on the relevant category): 1. Nano-Technology 6. Forensic Science 11. Laser & Opto-Electronics 2. Anatomy 7. Physiology 12. Computer Communication & Network 3. Economics 8. Water Resource Management 4. Petroleum Engineering 9. English Literature 5. Mining/Mineral Engineering 10. Modeling & Simulation 4.a )Research Publication (Use extra sheet whe re required): Please attach the copy with your application Sr. No Title of Area of Published in Impact Factor of Research Research International/Local Date of Journal in which paper Journal (Give full Publication your paper was name of Journal) published Page 4 of 11

5 5) Employment Details Name of Employer Category of Designation Period Nature of Job details with Address (use Employer(Federal/ with Grade served Job (Teaching, extra sheets where Prov Govt, Semi- (BPS, Group (Regular/ R&D, Service, necessary) Govt, Autonomous, etc. if Contract Technical, other Fro m To Corporation, applicable) etc.) etc) Private) Last Drawn Gross Salary: (attach pay slip) (Rs.) /month 6. Family Information: Father s Information: Full Name: Is your father alive:yes If yes please provide the following: No Age: Telephone Number: Mobile Number: Address: Is your father currently employed? Yes No Current Employment ( if applicable) Designation: Date of Joining(dd/mm/yy) Spouse s Information (please leave blank if not applicable) Full Name: Age: Telephone Number: Mobile Number: Address: Is your spouse currently employed? Yes No Current Employment (if applicable) Organization: Page 5 of 11

6 7. Total Income: (a) Please specify Annual income information for each member of your family, including yourself and your spouse (if applicable). Use a separate sheet if needed. Specify monetary values in Rupees. Father: Mother: Particulars Annual Salary Business Income (if any) Total Guardian: Self: Spouse: Others(s): Total (b) Please specify Annual income information from the sources mentioned below: a. Agriculture Income: Rs. b. Income from Savings (Interests/Dividends): Rs. c. Pension: Rs. d. Real Estate Holdings: Rs. e. Support from Relative(s): Rs. f. Other (please specify): Rs. Total Annual household income: Rs. (c) Do you foresee a significant increase or decrease in your family income next year? No Yes If yes, please explain: Page 6 of 11

7 8. Total Assets: (a) Is the house you live in owned by your family? Yes Year of Purchase: Original Purchase Present market value(rs.): Price (Rs.): No Please explain why (e.g. living with grandparents, inherited, etc): House plot size (in Kanals/Marlas or Sq. Feet): Address: (b) Does your family own any other plot(s), house(s), or any other type of land(s) Yes No If you answered YES to the above, please provide the following information on each of these piece(s) of land(s) Plots Houses Buildings Land Other (Specify): Numbe r of Locality Area (Kanals/Marlas or Sq. Feet) (c) Please specify individual assets for each member of your family, including your self and your spouse (if applicable). Use a separate sheet if needed. Specify monetary values in Rupees. Particular Father/Guardian: Mother/Guardian: Self: Business Savings and Land and Agricultural Investments Building Land Area/location of Agricultural Land Spouse: Other(s) (d) Does your family own any automobiles(s) Yes No If Yes, Make Manufactured Year Engine CC Value in (Rs) Page 7 of 11

8 9. Total Average Family Expenses(Annual): Rupees a) Educational Expenses b) Food c) Medical Expenses d) Rent or Mortgage (if applicable) e) Fuel and Car Maintenance: f) Loan Payments g) Clothing h) Electricity Bill i) Mobile Phone Bill j) Entertainment: k) Servants Salaries: l. Taxes: m. Telephone Bill: n. Vacations: o. Other (please specify): Total Annual Expenses If the monthly/annual disposable income is negative, kindly explain the reasons for the gap and any arrangements through which the differential is being met by the family. Are there any outstanding loans? Yes No If yes, please indicate loans taken from: Particular Bank (specify name): Relative (specify relationship): Credit Card: Amount (Rs.) Repayment due on (mm/yy) Employer: Other(please specify): Page 8 of 11

9 10. Detail of Fee/Living Expenses on the Degree Programme: 10-a) Requirement of funds for degree: (Please mention all the amounts in Pak Rupes) Total expenses for the Re quirement Per Semester Per Year degree course (Approximately) (Rs) (Rs) (RS) Duration of Study Tuition Fees Rupees Boarding Lodging Air Fair Books Misc Total (a) 10-b) List the Agencies, Foundations and/or Governme nts to which you have Applied for Financial Aid Agency/Foundations/Government Applications Date Award Notifications Date Expected Amount (Rs.) 11. Statement of Purpose a) How will the proposed degree be of benefit to Pakistan/Khyber Pakhtunkhwa Page 9 of 11

10 (b) What skills and knowledge do you hope to gain from your studies? How do you propose to use them (if possible, list specific actions) on return to Pakistan? (c) Is there anything else you would like to add in support of your application for this scholarship? (d) How do you relate the proposed studies to your previous study/achievements (c) Where would you like to jo in in Pakistan after co mplet ion of your Ph D studies? [only for those applicants who are not already emp loyed in Pakistan] Page 10 of 11

11 12. FOR EMPLOYED APPLICANTS ONLY NOC BY THE HEAD OF DEPARTMENT This is to Certify that Mr./Ms. Son/Daughter of Mr. is regular employee of this Organization as Since. His/Her educational, employment particulars and other statements as stated in the foregoing columns have been checked and verified with the original documents. It is hereby affirmed that in the event of his/her selection for the award of scholarship. He/She will be released on study leave for the total duration of the research program which on average is 6 months. Date: Signature: Name & Designation: (Head of Department/Institution) Full Address: Office Stamp : Signature 13. Undertaking: I solemnly verify that the particulars listed above are correct to the best of my knowledge. In case any misrepresentation is identified by the Department at any stage, my scholarship will immediately be terminated. Consequently I will be liable to pay back the entire amount, released by Department under various expenditure heads, against my scholarship. The Department shall reserve the right to initiate legal proceedings at any stage in case of violation of any agreement with the Department. If selected, I will comply with all the terms and conditions, bond for returning back to Pakistan and serve for the defined period and other requirements prescribed by the Department. Decision of the Scholarship Management Committee shall be final and cannot be challenged in any court of law & I will abide by the decision. Applicant Signature: Date: Attestation (for candidates who are not currently employed): I hereby verify that information provided is true as per my knowledge. Name of Attesting Authority Designation: C.N.I.C No. Signature & Stamp: Page 11 of 11