Domicile Application Form by kez13588

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									                                        APPLICATION FORM

                ADMISSION IN FATIMA JINNAH MEDICAL COLLEGE, LAHORE
             (07 SEATS RESERVED FOR REAL DAUGHTERS OF FEDERAL GOVT SERVING CIVIL EMPLOYEES )         Latest
                                     ACADEMIC SESSION 2008-2009                                    Photograph

                         (THIS PAGE IS TO BE FILLED IN BLOCK LETTERS ONLY)

Name                                                                                               ____
Father’s Name _       ____     __________________________________________________________
Mother’s Name ___       _______________________________________________________________
(If the eligibility is claimed on the basis of mother’s employment in Federal Government)
Permanent Address                                                                                  ____
Current Mailing Address                  ______________________________                            ____
Phone No (Residence)                     ______ Cell No. _________________(Office)            __________
Date of Birth                                            District of Domicile                      ____
N.I.C. No.                                               Date of Issue                             ____
Intermediate Science (Pre-Medical) Passed in Year _____________________________________
(Or Equivalent Examination)
Seat No.                                         Examination Centre                           __________
Division/Grade ___________________Total Marks Obtained/Total Marks _____________________
Matriculation Exam. Passed in Year                                Seat No.          _______        ____
(Or Equivalent Examination)
Division/Grade __        ____________Total Marks obtained/Total Marks_______________________
Hafiz-e-Quran Certificate ( ) Yes ( ) No         Date of Issue __________________________________
Entry Test Roll No. _______________Examination Centre _________________________________
Province _______________

Place           ___
Date                                                                       _______________________
                                                                             Signature of Applicant
                                 DECLARATION BY THE CANDIDATE

THIS IS TO CERTIFY THAT I HAVE READ THE RULES AND REGULATION GOVERNING THE O7 SEATS
RESERVED FOR THE REAL DAUGHTERS OF FEDERAL GOVERNMENT SERVING CIVIL EMPLOYEES AT
FATIMA JINNAH MEDICAL COLLEGE LAHORE AND AGREE TO ABIDE BY THEM. I ALSO HEREBY AGREE
THAT IF ADMITTED, I SHALL CONFORM TO ALL PRESENT RULES, REGULATIONS AND ORDER IN
FORCE IN THE MEDICAL INSTITUTION INCLUDING THOSE THAT MAY BE MADE HEREAFTER FOR THE
ADMISSION TO THE INSTITUION. I UNDERTAKE THAT SO LONG AS I AM A STUDENT OF THE
INSTITUTION I WILL DO NOTHING EITHER WITHIN OR OUTSIDE THE INSTITUTION PREMISES THAT
MAY INTERFERE WITH ITS ORDERLY ADMINISTRATION AND DISCIPLINE, OR MAY BRING THE
INSTITUTION OR ITS ADMINISTRATION INTO DISPUTE. I FURTHER UNDERTAKE THAT IF I FAIL TO
OBSERVE THE DISCIPLINE OF THE INSTITUTION I CAN BE EXPELLED OR PUNISHED IN ANY OTHER
WAY BY THE PRINCIPAL AT ANY TIME DURING THE COURSE OF MY STUDIES AT THE INSTITUTION.


DATE ________________                                               ________________________
                                                                     SIGNATURE OF APPLICANT


                                                   Page 1 of 4
                            SOLEMN AFFIRMATION BY PARENT


I, ___________________________________ FATHER/MOTHER OF MISS __________________________,
AN APPLICANT FOR ADMISSION IN FATIMA JINNAH MEDICAL COLLEGE LAHORE DO HEREBY
SOLEMNLY AFFIRM THAT ALL STATEMENTS OR PARTICULARS MADE IN THE ABOVE APPLICATION
ARE TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF. I AM AWARE THAT IF ANY OF THE
STATEMENTS MADE IN THE ABOVE APPLICATION IS FOUND TO BE WRONG, MY DAUGHTER WOULD
BE LIABLE TO BE REFUSED ADMISSION IN FJMC EVEN IF OTHERWISE ELIGIBLE AND IF ADMITTED
WOULD BE LIABLE TO EXPULSION FROM THE INSTITUTION AT ANY TIME DURING THE COURSE OF
HER STUDIES, IN WHICH CASE, FEES AND OTHER DUES PAID BY HER AT THE TIME OF EXPULSION
SHALL BE FORFEITED. FUTHERMORE, SUCH A WRONG OR FALSE STATEMENT WOULD MAKE MY
DAUGHTER AND ME LIABLE TO ANY FURTHER DEPARTMENTAL OR LEGAL ACTION, WHICH THE
GOVERNMENT MAY DEEM NECESSARY. I FURTHER SOLEMNLY AFFIRM THAT I AM A FEDERAL
GOVERNMENT CIVIL EMPLOYEE SERVING IN THE MINISTRY/DIVISION/ATTACHED DEPARTMENT
NAMELY_____________________________________________________AS ________________________
IN BPS _________, AND THAT THE APPLICANT IS MY REAL DAUGHTER.



PLACE ______________________                                ____________________________
                                                               SIGNATURE OF FATHER/MOTHER

DATE   __________________                                    NAME:   ______________________

_______________________________________________________________________________________


               VERIFICATION BY THE MINISTRY / DIVISION / DEPARTMENT
           (TO BE SIGNED BY THE AUTHORIZED OFFICER NOT BELOW THE RANK OF DEPUTY SECRETARY
                          OF THE ADMN WING OF THE CONCERNED MINISTRY/DIVISION)




IT IS VERIFIED THAT MR/MS _______________________________________________ IS, TO THE BEST
OF OUR KNOWLEDGE, FATHER/MOTHER OF THE APPLICANT AND THAT THE ABOVE NAMED
OFFICER/OFFICIAL IS A FEDERAL GOVERNMENT CIVIL EMPLOYEE. IT IS FURTHER VERIFIED THAT
THE    ABOVE    NAMED     OFFICER/OFFICIAL       IS    A   SERVING     EMPLOYEE      WORKING   AS
_________________________ IN BPS _________ IN THE MINISTRY/DIVISION/DEPARTMENT OF
________________________________________________




DATE: ___________________                                  _____________________________________
                                                                        Signature
                                                           NAME:________________________________
                                                           DESIGNATION: ________________________
                                                           PHONE NO. __________________________

                                                                AFFIX OFFICIAL STAMP PLEASE




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                                                                                   MOST IMMEDIATE
                                         No.F.6-1/2008-MER
                                        Government of Pakistan
                                           Ministry of Health
                                               *********
                                                                                     th
                                                                      Islamabad, the 17 September, 2008


                                     OFFICE MEMORANDUM

Subject:      ADMISSION IN 1ST YEAR MBBS CLASS IN FATIMA JINNAH MEDICAL
              COLLEGE, LAHORE AGAINST SEVEN RESERVED SEATS FOR REAL
              DAUGHTERS OF FEDERAL GOVERNMENT SERVING CIVIL EMPLOYEES –
              ACADEMIC SESSION 2008-2009.


               Applications are invited from the real daughters of Federal Government Serving
Civil Employees for seven reserved seats (04 for Non-Gazetted and 03 for Gazetted Employees)
for admission in 1st year MBBS Course in Fatima Jinnah Medical College (FJMC) Lahore during
the Academic Session 2008-2009

2.             Federal Government Employees, both Gazetted and Non-Gazetted, who desire their
real daughters to be considered for admission in 1st year MBBS Course in FJMC Lahore against
the reserved seats, should route applications on enclosed Application Form, duly completed by the
candidates through their respective Ministry / Division. Applications duly certified by the competent
authority alongwith following documents of the candidates must reach to the undersigned at the
earliest but not later than 18th October, 2008:

              1.     Matriculation Certificate
              2.     FSc Certificate and detailed marks sheet of FSc.
              3.     National Cadet Corps Training Certificate, if applicable.
              4.     Domicile Certificate.
              5.     Copy of Admit Card already taken to compete on provincial open merit seats.
              6.     One Self-addressed envelop duly stamped.
              7.     Hafiz-e-Quran certificate duly registered/recognized (if any).
              8.     Two Photographs (Name in block letters at the reverse of Photograph)

3.            Following conditions shall apply for the eligibility:

              a) Adopted daughters of the Federal Government Serving Employees are not
                 eligible for the subject reserved seats. (The forwarding authority is required to
                 clearly indicate and certify that)
              b) Either of the parents is a Federal Government Serving Civil Employee and the
                 applicant is his / her daughter.




                                               Page 3 of 4
                                                     -2-

                 c) All candidates are required to apply to the concerned Admission Board in their
                    respective province for admission against the open merit seats.
                 d) A copy of the Admit Card to Entry Test is required to be attached with the
                    application form.
                 e) In case of selection on open merit, the candidate is required to inform this
                    Ministry immediately so that her candidature for the reserved seats for Fatima
                    Jinnah Medical College, Lahore may be removed from the list of candidates. In
                    case a candidate hides her selection on open merit from the Ministry, her
                    admission shall be liable to be cancelled in FJMC at any stage of her studies, if
                    so discovered.

4.            The final authority in the selection and nomination for these 07 seats is the Ministry
of Health and no petition whatsoever will be entertained on this account.

5.               Application duly completed in all respects must reach to the Ministry of Health
(Room No. 211, C-Block, Pak Secretariat, Islamabad) not later than           18th October, 2008.
Applications received after closing date or incomplete applications will not be entertained. The
Application Form can be obtained from the official website of Ministry of Health
(www.health.gov.pk).

6.            All Ministries/Divisions/Departments are requested to kindly widely disseminate the
above information amongst all the employees, and be kind enough to provide the attached
Application Form to the eligible candidates.


Note:    Autonomous Bodies / Semi Autonomous Bodies / Corporations and Armed Forces Departments /
         Organizations, not included in schedules I & III of the Rules of Business, 1973, the daughters of
         employees of such organizations / bodies are not eligible for admission against these seats.



                                                                    (Dr. Zafar-ul-Haq Lodhi)
                                                                 Deputy Director General Health
                                                                      Ph: 051-9204981
                                                                      Ph: 051-9208867

Secretaries of all Federal Ministries/Divisions




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