Pakistan Atomic Energy Commission Model College
Admission / Registration Form
Please Note: All the columns of this Form should be filled in with capital letters. Incomplete Form shall not be entertained. Write ’Nil’ where not applicable.
Addmission Required For Class: Session:
Example 2014-15

Paste 1" x 1.25" Photograph here Do not use Stapler or Pin

Groups offered from Class IX onwards: Pre.Engineering / Pre Medical / Gr. Science / Arts 1st Priority: 2nd Priority: 3rd Priority:

Student’s Information
Name: Student’s CNIC No:
As of NADRA B-Form

Hafiz-e-Quran:
Male / Female Yes / No

Is Candidate Special:
Yes / No ( Special means if candidate is with any disability, Medical Certificate required.)

Date of Birth:
As of NADRA B-Form: (Example: 22-Feb-2001)

Gender:

Religion:

Blood Group:

Domicile Dstrict :

Any Medical Problem:

Mark of Identification: E-mail: Postal Address: Permanent Address: Mobile No : Phone No :

Academic Information
Exam Passed Year Subjects Institution Board/University Percentage Obtained

Father’s Information
PIN No :
Mandatory for PAEC Employees As alloted by PAEC HQ

Name:

CNIC No:
As of NADRA

-

-

Designation: Profession :

Department/Centre:

Mother’s Information
(Mandatory for PAEC Employee) PIN No :
As alloted by PAEC HQ

Name:

CNIC No:
As of NADRA

-

-

Designation:

Department/Centre:

Profession :

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Guardian's Information
PIN No :
If alloted by PAEC HQ

Name:

CNIC No:
As of NADRA

-

-

Designation: Profession :

Department:

Fee Paying
Who will Pay the College dues. Tick Father

R

one against available options. As fee concession is applicable on the basis of the selection made Mother Guardian

Declaration
I certify that the information provided is complete to the best of my knowledge and belief. I understand that any misrepresentation or material omission on this From or other document(s) will result in removal of student from the institute. Moreover, If admission is granted the student will obey the institution’s rules and regulations implemented from time to time.

Date:

Signature of the Student:

Signature of Parent / Guardian:

Enclosures (Attach attested copies)
a). Marks Sheet(s) / Certificate(s) / Report(s). b). Father’s / Mother’s / Guardian’s CNIC. c). B-Form (NADRA) of the Candidate. d). Hafiz-e-Quran Certificate. e). Disability Certificate. For Office Use Only
Test / Interview Date & Time: Remarks:

Please Note:
Student's Name: Student’s CNIC No:
As of NADRA

Acknowledgement ( For office use only ) Submission of this Application Form does not guarantee the admission, as admission to the College is subject to the fulfillment of laid down criteria/procedure(s).

Remarks:

-

a). Marks Sheet(s) / Certificate(s) / Report(s). b). Father’s / Mother’s / Guardian’s CNIC. c). B-Form (NADRA) of the Candidate. d). Hafiz-e-Quran Certificate. e). Disability Certificate.

Test / Interview Date & Time:

Date:

Signature :
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