Application Form for Scholarships

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Higher Education Commission
English Language Teaching Reforms (ELTR) Phase II
ELTR SCHOLARSHIPS FOR ENGLISH TEACHERS
H-9, Islamabad-Pakistan
Application No & Receiving Date: ______________
(For HEC use only)

1. Program Applied For:

__________________ Registration No. ___________________
Attach 2 Latest
photographs
with Name
written at the
back

2. University where Enrolled: _________________________________________________
3. Bank Receipt Date: _____________Amount: ________ Bank Branch: ________________
4. Candidate Name: ________________________ Father’s Name: ____________________
5. Gender: _____________ Religion: ___________ Nationality: ______________________

6. Domicile: ____________ _____Marital Status: ______________ Date of Birth: __________________________
7. Age (as on Advertised closing Date): ______________________ CNIC: _________________________________
8. Postal Address: _____________________________________________________________________________
9. Mobile Number: __________________________ E-mail: ____________________________________________
10. Obtained NOC? (For College faculty from the Directorate of Colleges & University faculty from Vice Chancellor /
Registrar) ___Yes / No___ Attached Agreement on Judicial Stamp paper @ Rs. 100 _____Yes / No___________
11. Academic Qualifications:
Degree / Certificate

Board / University

Field of
Study

Start
Year

End
Year

Obtained
Marks

Total
Marks

%age /
Grade

12. Employment Record / Experience (if any)
Post Held

Designation

Institute / University

Start Date

End Date

Scale

Status
 Permanent
 Contract
 Visiting

13. Undertaking by the Candidate:
I certify that all information provided by me in the above application form is correct. I have read and understood
the conditions of the award of this scholarship advertised by the HEC.In case any information is found to be
incorrect, it will disqualify my candidature.
Date: ______________________

Candidate’s Signature: ________________________________

14. Recommendations by VC / Registrar / Principal:
___________________________________________________________________________________________
Signature of VC / Registrar / Principal: __________________

Official Stamp: ____________________________________

Sample Agreement between Candidate & HEC (ELTR-Scholarships)
(On Judicial Paper of Rs. 100)

1. I___________________S/O-D/O_____________, working as ________ in Govt. College/University
___________________, from _________to_______________(date) do hereby undertake in the following terms:
2. I hereby declare that I will attend this program till its completion duration and will serve for a period of one year
immediately following the completion of the program.
3. I also hereby undertake that in case of dropout from the course at any stage and for any reason whatsoever, I
shall refund the full tuition fee and stipend to ELTR Project HEC.

Deponent
Head of Department/Institution
Signature________________
Name:_____________________

Signature _____________________

Date___________________
Designation:________________

Date _________________________

Signature: _________________
Date: _____________________

Witness

1.______________________________
Official Stamp
CNIC____________________________
2._______________________________
CNIC____________________________

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