Shalamar Medical and Dental College
Application for Financial Assistance
Important Note
Submission of an application for financial assistance does not guarantee award of financial assistance.
The SMDC expects honesty from students and their parents. Incorrect information or concealment of
information will result in denial of financial assistance. The SMDC also reserves the right to take
strict disciplinary action against such applicants.
The financial assistance programme aims to assist students who do not have resources to generate
funds to meet their educational expenses. Serious efforts must be made to raise funds (loans and
scholarships) from all other sources before applying to SMDC for assistance. Applications that
do not bear evidence of efforts for raising funds from other sources may be rejected.
SMDC reserves right to verify the information and evidence from the documented source or third
party and conduct inquiry.
In case applicant got any scholarship, the assistance awarded will be reduced by the same amount of
scholarship.
The students have the right to apply for a review ONCE if not satisfied with the decision of Financial
Assistance Committee. However, the decision of the SMDC to such a review will be final
DOCUMENTATION REQUIRED:
The application MUST be supported by legible photocopies of evidence regarding details stated in this
form. At the minimum, following documents for all earning members of the family, including self as
applicable should be provided.
o Latest salary slips (of last three months)/certificates/Affidavit in case of
business (all earning members)
o Copy of latest Income Tax return and Wealth Tax statements of all earning
members (Where applicable)
o Bank statement of all accounts for all members and/or business in the family.
(previous 12 months)
o Income and Expenditure details for last 1 year (in case of business)
o Evidence of educational expenses paid for other family members (for last six months)
o Copy of Electricity, Gas and Telephone / Mobile Bills (for last three months)
o Documentary evidence with complete details of all assets / properties owned
(house, plot, business, agricultural land/ car(s) etc.)
o Lease/Rental agreement of all Properties taken/given on lease/rent
o Documentary evidence of all Investments held (Saving certificates, fixed deposits,
insurance policies, etc.)
o Documentary evidence of loans taken and its updated repayment schedule.
Student Application No. ______________
Name of Student: ________________________
Enrolment Number ________________________
Date of Birth ________________________
CNIC Number ________________________
Domicile ________________________
Residential Address
______________________________________________________________________________
_________________________________Tel. # (Res)_____________Cell Phone # ___________
E. mail ID ____________________
Marital Status ____________________
Name of educational Institutions last attended:
1) Secondary School ____________________________________
2) Higher S. School ____________________________________
3) University ____________________________________
Name and other details (including contact number) of student’s Loan / scholarship availed.
If any:
a) Existing ___________________________________________________________
b) Percentage ___________________________________________________________
c) Past ___________________________________________________________
Father / Guardian Name _______________________________
CNIC Number _______________________________
Residential Address
______________________________________________________________________________
_______________________________Tel. # (office)_____________Cell Phone # ___________
E. mail ID____________________
Present occupation (Give full details) _____________________________________________
Service Name of Company Designation
/Employer
Business Nature of Business
Retired Date of Retirement Last drawn Salary
Monthly Income Gross ______________________ Net ____________________
Annual Income Gross ______________________ Net ____________________
Mother Name _______________________________
CNIC Number ________________________
Residential Address
______________________________________________________________________________
_______________________________Tel. # (office)_____________Cell Phone # ___________
E. mail ID____________________
Present occupation (Give full details) _____________________________________________
Service Name of Company Designation
/Employer
Business Nature of Business
Retired Date of Retirement Last drawn Salary
Monthly Income Gross ______________________ Net ____________________
Annual Income Gross ______________________ Net ____________________
Other Supporting Members (if applicable)
Name _______________________________
CNIC Number ________________________
Residential Address
______________________________________________________________________________
_______________________________Tel. # (office)_____________Cell Phone # ___________
E. mail ID____________________
Present occupation (Give full details) _____________________________________________
Service Name of Company Designation
/Employer
Business Nature of Business
Retired Date of Retirement Last drawn Salary
Monthly Income Gross ______________________ Net ____________________
Annual Income Gross ______________________ Net ____________________
Type of Accommodation (please tic/write in column applicable)
Type of Rented * Owned ** Provided by Number Total Area Total Covered
Accommodation Employer of Rooms of Plot Area
** (Sq. yards) (Sq. yards)
Flat
Townhouse
Bungalow
Other
*(please provide rent agreement)
** (please provide documentary proof)
Total members residing with the family: __________________________________________
Any other house or flat owned by the family: Yes □ No □
If yes, please give details regarding location, size, rent, etc., on a separate sheet.
Agricultural land owned by family: Yes □ No □
If yes, please give details regarding location, size, rent, etc., on a separate sheet.
Other organizations / institutions approached for financial assistance.
(Bank, father’s / mother’s / guardian’s employer etc)
Name of organization Amount Applied for Outcome
Details of Liabilities:
a) Amount outstanding ______________________________________________________
b) Nature
______________________________________________________
c) Repayment schedule ______________________________________________________
d) Loan / Debt Maturity date ________________________________________________
e) Reason for obtaining Loan/Debt ___________________________________________
Details of Assets / Properties
Value of Assets Father Mother Family Self Other Supporting Total
Members hands
Business
Land & Building
Vehicle(s)
Saving Accounts
& Deposits
Investments
Others
Total
Annual agricultural income of family _____________________________________________
Any other form of income of assets or otherwise ____________________________________
Total family income ____________________________________________________________
Detail of Annual family expenditures (please provide appropriate evidences)
1. House Hold Expenses:
House Rent ________________________________
Maintenance of House ___________________________________
Utility Bills: ___________________________________
Government Taxes (Property etc) ____________________________
Transportation _________________
Annual Food / Grocery _________________
Servant _______________________________
Clothing __________________________
Medical Expenses ____________________________
Travel Within Pakistan_________________ overseas _______________________
Entertainment: Hotel Expenses _________________ Club Membership ____________
Other Expenses (Please provide details in attachment) _______________________________
Total House Hold Expenses ______________________
2. Educational Expenses
(Excluding Applicant’s expenses at SMDC)
Dependent family Members ________________
Name and Age Occupation (If Name of Institution (If Fee (Per
Relation working) studying) Month)
Total Educational Expenses _____________________
3. Other Expenses
Legal Expenditures _______________________
Loan Repayment: Other financial institutions (Provide evidence) ______________________
Donations _______________________
Payment of Insurance Premium: family/car ______________________
Total other Expenses _____________________
Grand Total (1+2+3) ______________________
Undertaking
1. I understand that submission of this application does not guarantee the award of
financial assistance, nor does it absolve me of any financial responsibility in relation to
study at SMDC.
2. The information given in this application is complete and true to the best of our
knowledge. I understand that concealing information or providing incorrect
information will result in denial of financial assistance and may also result in strict
disciplinary action.
3. I agree to abide by the decision of the financial assistance committee.
Signature of Applicant: ________________________ Date: _______________
Signature of Parents/Guardian: ________________________ Date: _______________
