COMSATS Institute of Information Technology CIIT/FSPS-I/B-(a)
30, Sector H-8/1, Islamabad Ph: (92-51) 9258481-82, 4448371-72, Fax: (92-51) 4442805
Qarz-e-Hasna
(Application Form)
Session: Fall/Spring.
PARTICULARS OF THE APPLICANT
Students Name: ---------------------------------------Registration # ------------------------------
Overall Semester: ------------------------------------- Session Spring / Fall -----------
Address:------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------
PTCL #: ------------------------Mobile # ------------------------------------
1. FathersName:_________________ Computerized N.I.C. No ________________________
2. Status: Alive Deceased
3. Professional status: Employed Retired Business Owner
4. Name of Company/Employer: ___________________________________________________
5. Address: ____________________________________________________________________
6. Tel (Off): ______________________________ Mobile: ______________________________
7. Occupation Type: ____________________________________________________________
8. Designation & Grade ( BPS/ SPS/PTC etc): ________________________________________
9. Total Gross Monthly Income from all sources __________ NTN____________________
10. Any Other Supporting Person (Mother/ Guardian/ Brother/ Sister/Family Relative/Guardian):
11. Name: ___________________________ Relationship: _________________________
12. Address: ____________________________________________________________________
13. Tel(Off/Res) _______________Mobile No._______________ CNIC no.__________________
14. Occupation __________________________________________________________________
15. Designation _____________________Name of Company/Employer _____________________
16. Total Monthly Gross Income (Salary/ Pension/ Others) ___________________________
1/4
Affidavit
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 the grant of the Qarz-e-Hasna, will have to refund all payment
received and a penalty levied.
The CIIT reserves the right for verification of the information given in this form.
Signature of Parent/Guardian_____________________
Name:________________________________________
CNIC No.____________________
Date: ________________________ _______________________
Signature of Applicant
For Office Use only
It is hereby recommended that Mr/Ms.-------------------------------------------------S/D of ------------------------
RollNo.----------------------------Semester---------------------------granted an amount of Rs.--------------- as
Qarz-e-Hasna for---------------------semester ------------------, is recommended after verification of the
given information.
-----------------------------
Convenor of FSPC
Date:----------------------
Note: (Copy of B.Form must be attached alongwith this application form)
Please Submit your from duly filled at following address:
Front office,
Chakshazad Campus,
Islamabad.
Tel #: 9########.
2/4
SPECIMEN CIIT/FSPS-I/B-(b)
(To be executed on Rs.15/- Non-judicial Stamp Paper)
DEED OF AGREEMENT
FOR QARZ-E-HASNA (QHP)
This agreement is made, on the ..day of .2009, between
(1) Mr. / Miss (name of the student) son / daughter of Mr. ( Fathers name ) resident of -------------------
--------------( Permanent Address ) here after called Student, and
(2) COMSATS Institute of Information Technology, Islamabad Campus here after called CIIT, Islamabad.
WHEREAS Mr. / Miss-----------------, has been admitted by CIIT Islamabad for the degree of BS----------(
subject) has agreed to accept the terms and conditions governing this Financial Support Program.
Now this deed witnesses as under:
i) This Financial Support in term of Qarz-e-Hasna given to the student shall be initially valid for one
semester (Semester Spring / Fall ------------).
ii) The Student shall fully abide by the decision on Qarz-e-Hasna by the FSPC constituted for the
purpose of awarding financial support as per CIIT policy.
iii) The Qarz-e-Hasna given to the student shall be strictly subject to the decision of the, Financial
Support program Committee (FSPC) and may not be challenged in any case.
iv) The student shall refrain from engaging himself in any political, commercial or any other activity
incompatible with his program of studies.
v) The student will be liable to disciplinary action as follows:
a) If he violates any condition laid down in the Bond for Qarz-e-Hasna program, CIIT reserves
the right to take strict disciplinary actions against him.
vi) The student is liable to disqualification from Qarz-e-Hasna or such other disciplinary action as
CIIT may consider appropriate, if:
i) he violates any of the foregoing conditions, or
ii) he is found to have made any misstatement therein before.
vii) The student shall conform strictly the terms and conditions required for the financial support
program.
viii) If the student found involved in any unlawful activity at any stage during stay at CIIT, the institute
shall have the right to cancel admission without notice.
AND THE STUDENT FURTHER COVENANTS, that in case of breach of any of the above terms and conditions
as well as the rules those governing Financial Support Program as directed by the CIIT (concerned campus) for the
specified period, Student shall be financially penalized, failing which this amount shall be realizable from the
following two Guarantors who stand sureties on my behalf jointly and severally, who have also signed this surety
bond/undertaking below.:
3/4
IN WITNESS WHEREOF, the parties aforementioned have signed this deed in token of acceptance thereof.
Additional Registrar Student
Signature -------------------- Signature ____________________
Name -------------------------- Full Name: .
Date ---------------------------- Designation/Dept:
NIC No: .
Phone No: ..
Address: .
Date: .
Guarantor/Surety No.1 Guarantor/Surety No.2
Signature ______________________ Signature:____________________
Name: ________________________ Name: ______________________
Relationship with the Student Relationship with the Student
______________________________ ____________________________
NIC #_________________________ NIC #_______________________
Address: ______________________ Address: ____________________
______________________________ ____________________________
Dated: ________________________ Dated: ______________________
Witness No. 1 Witness No. 2
Signature:___________________ Signature:____________________
Name :____________________ Name :_____________________
NIC # _____________________ NIC # ______________________
Address:____________________ Address:_____________________
___________________________ ____________________________
Dated: ________________________ Dated: ______________________
4/4
