The Aga Khan University

S Medical College Attested 7 days old

BB Application for Admission - I
passport size photograph
M bearing the name of the
11 applicant at the back.
20 (Please do not attest
on candidates face)

Please staple
PLEASE WRITE IN CLEAR HANDWRITING OR TYPE
Please note that incomplete and incorrect information will disqualify the candidate
from the admission process.
(Please use Block letters)
(Please leave blank).
A. Personal Data

Name: Father’s Name:

Date of Birth:______________ ______________ __________________ __________ ____________

Day/Month/Year Place of Birth Country of Citizenship Male/Female Single/Married

Correspondence/Contact Address:
Please do not use short forms. Candidates resident overseas are required to state addresses where they can be contacted
in person. This address should be noted on the self addressed envelope.
_________________________________________________________________________________________________
_______________________________________________________________________ City: _________________

Post Code: __________________ Telephone #:_____________________ Fax #:____________________

E-mail Address:_____________________________________ Mobile #: ___________________________

Permanent Address (if different from correspondence address above)

_________________________________________________________________________________________________
_______________________________________________________________________ City: _________________

Post Code: __________________ Telephone #:_____________________ Mobile #:____________________

B. AKU Medical College Admission Test

Circle only one Centre for the Admission Test and yo ur preference of Interview Centre, if shortlisted.

For Applicants writing AKU Admission Test in Pakistan

AKU Admission Test Interviews (if shortlisted)
Hyderabad Karachi Lahore Multan Quetta Rawalpindi Gilgit Chitral Karachi Lahore Rawalpindi

For Applicants writing AKU Admission Test Overseas

AKU Admission Test Interviews (if shortlisted)
Dubai Houston London Nairobi New York Singapore Toronto Toronto London New York Houston

C. Did you apply to AKU previously: Yes No

If yes: Year of previous application(s) ________________ Application Number(s):___________

Official: Please do not write in this space:

Complete Repeat Provisional Incomplete Pakistani OHS BRT AMR OTH

Application received through: Mail Counter

Documents awaited:

Date: ________________ Received by__________________ Fee: Local Foreign

Mode of Payment: Cash Draft Online Payment

D. Academic Qualifications Please complete the sections and enclose the mark sheets where applicable.
Pakistani System of education

Secondary School Certificate (SSC)

Name of Institution: _______________________________Board of Education: _______________________
City and Country of Study: _______________________ SSC year of completion: ___________

Academic Qualification Marks / Division /Grade Year of Completion

SSC

Higher Secondary School Certificate (HSC)

Name of Institution: _______________________________Board of Education: _______________________
City and Country of Study: _______________________________________________________________
Status of Programme: Enrolled Completed HSC year of Completion: __________________

Academic Qualification Marks / Division / Grade Year of Completion

HSC I
HSC II

British System of Education

Ordinary Level (O-Level)

Name of Institution: ______________________________________________________________________
City and Country of Study: ____________________ Year in which you completed O-Level: ___________

O-Level Subject Grade and Percentage Year of Completion

Biology
Chemistry
Physics
English Language

Advance Level (A-Level)*

Name of Institution: ______________________________________________________________________
City and Country of Study: _______________________________________________________________
Status of Programme: Enrolled Completed Graduation Year: __________________

A-Level Subject Grade and Percentage Year of Completion

Biology
Chemistry
Physics / Mathematics
*Note: An equivalance certificate/ eligibility certificate (as applicable) will be required to complete your application.
 Other Systems of Education (Please complete as applicable)*

Undergraduate* Graduate*

American System Bachelors in Science (BSc)

Masters in Science (MSc)
Canadian System
If other please specify: ___________________
Others
Majors:
International Baccalaureate [IB] __________________________________________
HSc from Other Countries
__________________________________________
If other please specify: _____________
__________________________________________

Name of Institution: ______________________________________________________________________

City and Country of Study: _______________________________________________________________
Status of Programme: Enrolled Completed Graduation Year: __________________
Cumulative GPA/ Grade / Percentage: _______________________________

Subjects Grade/ Marks/ Percentage Year of Completion

Biology
Chemistry
Physics
Mathematics
Others:

*Note: An equivalance certificate/ eligibility certificate (as applicable) will be required to complete your application.
E. For Applicants following American and Canadian system of education:
(Please see brochure for eligibility and deadlines for completing requirements)

If shortlisted: SAT II / AP is required to complete your application.

Please specify: Are you opting for SAT II or AP : SAT II AP

If available and valid, please complete the section below:
Scores Month & Year
Biology _________ ___________
Chemistry _________ ___________
Physics _________ ___________
Mathematics _________ ___________

For awaited results please specify the date of the test you will be writing: _____________________

Please note: Minimum scores meet eligibility requirements only and may not be competitive for final selection.
(Please attach score sheet with the application if available)

F. Is PMDC Eligibility Certificate applicable for you: Yes No

G. Are you applying for any other programme in the Aga Khan University: Yes No

If Yes, please specify: ________________________________________

Please Note:
Aga Khan University reserves the right to revoke admission and registration if an application form is
discovered to be inaccurate or incomplete, or if supporting documents are discovered to be
fraudulent. Any applicant who presents a fraudulent document in support of an application for
admission may be identified to other universities and colleges.

Declaration:
.

The statements I have made in my application are true. I understand the implications
of not providing the equivalance / eligiblity certificate if provisionally selected. I
agree to conform to the discipline of the selection process and to accept the decision of
Aga Khan University concerning the evaluation of my application and the final
selection.

Date:________ Applicant signature: _______________ Parent /Guardian signature:_____________