APPLICATION FORM
FOR ADMISSION AS OVERSEAS STUDENT
IN MBBS / BDS (Session 2016)
Scan
Photograph
at DOW INTERNATIONAL MEDICAL COLLEGE (DIMC)
and DOW INTERNATIONAL DENTAL COLLEGE (DIDC)
if sending
by e-mail
DOW UNIVERSITY OF HEALTH SCIENCES, KARACHI
NOTE: Overseas seats at Dow Medical College will be offered on Merit cum choice basis to these candidates.
Please tick the category of seat opted:
MBBS
BDS
any
FILL THE FORM IN BLOCK LETTERS.
Name of Applicant
Father’s Name
Birth Location
Birth Date
Birth Country
Age on closing date
Marital
Status
CNIC NICOP
Religion
Home Address
Male
Female
Tel No.
(Present)
Mobile:
E-mail:
Home Address
(Permanent)
Nationality
Single
Name
of
Country
Dual
Passport No.
Date of Issue
Place of Issue
Expiry date
ACADEMIC RECORD
Do you have IBCC
Equivalence Certificate
Yes
No
If (No) did you apply for it
Yes
No
Do you have SAT II
Science Scores
in 3 Subjects
Yes
No
If (No) do you intend to
appear in SAT II
Yes
No
Physics/Math
(Biology, Chemisty, any other subject)
Year of
Passing
If (Yes) when?
Yes
Grades / GPA / Marks Grades / GPA / Marks
SUBJECTS
Obtained in
9th + 10th Grade
Obtained in
11th + 12th Grade
OR O Level
OR A Level
OR Matric
OR Interscience
Grades / GPA
Advance Courses
(If taken)
Biology
Chemistry
Have you applied elsewhere for Admission ......... Yes
No
(If Yes please mention details:
If admitted will you be able to join from the start of session 28th Dec. 2016 ............Yes
(If No then when mention, Possible date of joining:
Name and Address of School
(9th & 10th grade / O Level / Matric)
Name and Address of College
(11th & 12th grade / A Level / Interscience)
Name of University for (Advance) Course (If Studied)
You need Hostel Accomodation (Details on website)------------- Yes
No
No
No
Father’s Particulars
Religion
Name
Nationality / Citizenship
Tel. No.
Mobile No.
Place of Domicile
E-mail:
Passport No.
Place of Issue
(Pakistan)
Qualification
If dual Passport
(Mention Country)
Date of
Expiry
Profession
Occupation
Position
Sector
Employer / Company
Have you been visiting Pakistan?
Yes
How much time you have spent (in Pakistan)
No
Do you have any close relative in Karachi?
Yes
(If yes) His / Her Contact No.
No
Any Brother / Sister studying in Pakistan? If yes, where and in which program?
The progress or the complaints of your Son / Daugher should be communicated to both (father and guardian)
Yes
No
Guardians’s Particulars
Religion
Name
Nationality / Citizenship
Tel. No.
Mobile No.
E-mail:
Place of Domicile
CNIC No.
Passport No.
Place of Issue
(Pakistan)
Qualification
Date of
Expiry
Profession
Designation
Occupation
Employer
Relationship with Candidate
NOTE: INCOMPLETE FORM MAY NOT BE ACCEPTED
Documents Submitted
Certificate / Diplomas
Transcript of
Uptil 12th Grade
OR A Level
OR Interscience
12th Grade
OR A Level
OR Interscience
Yes
No
Left hand thumb impression of
Applicant
Yes
No
Yes
No
Copy of Overseas Passport of Candidate
Yes
No
Copy of Overseas Passport of Father
Yes
No
Copy of NICOP (Candidate)
Yes
No
Copy of NICOP (Father)
Yes
No
Copy of IBCC Equivalence / SAT II Scores
Yes
No
If AP Courses attended
(Transcript / attached)
(If not then undertaking to be submitted with possibel dates)
Applicant’s Signature
Father’s / Guardian Signature