bangladesh mbbs2014

7/27/2019 Bangladesh MBBS2014

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Registration No.

R E G IS T R AT I O N F O R M

M BB S/ B D S C ou r se s I n B a ng l ad es h

A ca de mi c Ye ar 2 014

Filled by NTS

Personal Information:

Use CAPITAL le tte rs a n d le a ve sp a ce s b e twe en wo rd s.

( City Co d e - Ph o n e No )(OFF.) (RES.) (Mobil e)

3. Name in Full:

Postal Address:

1 9

. Fathers Name:

5. Candidate CNIC# :

0. Phone No:

1. Place of Birth:

2. Pasport No:

3. Name of guardian:

4. Address of guardian:

(A). In Bangladesh:

6. Have you applied for admission in anyeducational institute in Bangladesh:

7. Name of the course to which admission is sought:

I f y e s , g i v e y ea r & d e c i s i on ,if any communicated to you

Note Candidate who desires to be considered for more than onecourse should submit separate application for each course

Yes

MBBS

No

BDS

(B). In Country of Domicile:

5. Name & Address of person to be notified in case of emergency:

Country of Birth:

Date of Issue:

Nationality:

A n y ot h e r t r a ve ldocument:

Nationality:

City:Postal City

District:

8. Email:

6. Gender:

Wr ite yo u r Co r r ect Date o f Birtho th er wise yo u will b e r ejected

Date of Birth:D M Y YD M Y Y

Male Femal e

Min istr y o f In ter Pr ovinc ialC oo r d in at io n ( IP C D iv is io n)

STN STN

. Desired Test City

Islamabad.

Lahore2.

Karachi3.

Peshawar4.

Quetta5.

Multan6.

Faisalabad7.

Fill Only One Box for Desired Test City (M andatory)

(Subject to a minimum of 200 candidates, other wise the candidates will be assigned next near est test city)

Ma nda t or y (writ e your own CNI C No also at t ached t he phot ocopy of your CNI C. O t her wise you are not Eligible )

( A l l c o r re s p on d e nc e w i l l b e m a d e o n t h i s a d d re s s )

A keyword (only 4 Digit s) provided by t he candidat e t osubmit correct ion query lat er f or correct ion in provisionalc a n d i d at e l i s t o n t h e N T S w e b s i te

. Authentication Keyword

Bank Online Deposit of Rs: 800/- from Designated Bank Branches.

B a n k N a m e & C o d e Deposit Date

* N o t e : A p p l i c a t i o n F o r m w i l l n o t b e e n t e r t a i n e d w i t h o u t O r i g i n a l D e p o s i t S l i p ( N T S C o p y ) h a v i n g B a n k S t a m p o n s l i p .

Paste your

recent

passport size

c o lo r p h ot o gr a ph

with Stapler

2 Picture


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HSSC/ A-Level( 1 2 Ye a r s De gr e e )

Language

19. Academic Information:

20. Proficiency of Language:

(Please attached your required document)

Cer tificate /Degr ee Level

Degr ee Name ObtainedMarks/CGPA

Year Passing

TotalMarks/CGPA

Institute/Boar d

SSC/ O-Level( 1 0 Ye a r s De gr e e )

Note: 1. NTS will not issue Roll No Slips to those who have not given their academic record accordingly.

M a j o r S u b j e ct

18. Domicile

Punjab1.

Balochistan3.

K h y b er P u k ht o o n kh w a2.

Sindh Urban4.

Sindh Rural5.

AJK6.

Fata Fana7.

(Mandator y)F i l l O n l y O n e B o x f o r D e s i re d D o m i c i l e

Excellent

Reading

Good Fair Excellent

Wr iting

G ood Fair E xcellent

Speaking

Good Fair

21. Cross check of basic criteria:

A. I h a ve se cu re d mo re th a n 65% marks i n SS C & H S SC o r eq u iv a le n t e x am ?

B. I have passed my SSC o r equivalent exam not before year 2009?

Yes

Yes

No

No

ndertaking By The Applicant:

_____________________________ d/ s/ w o f _________________________do hereby solemnly affirm that Ihave read and understood the conditions for appearing in the NTS Test and that I have filled the form as per instructionsgiven above and in the event any information contained herein is found to be untrue, I shall be liable to disciplinary actionwhich may result in cancellation of my test.

Date: ________________ Signature of the Candidate :__________________

S ch e du l e o f Test

Test Date: Sunday, 29th September 2013

1 1t h S e p t e mb e r 2 0 1 3Last Date of submission Application form:

By Hand submission of Application Form is not allowed.

M obile Phones are not allowed in Test Center premises.

A t t a ch y o u r r e c e nt P h o t o g ra p h , C N I C c o p y a n d O r i g in a l

Bank Deposit Slip NTS Copy.

Application should reach NTS office latest by last date of

submission of Application Form.

N T S w i l l n o t b e r e s p on s i b le f o r l a t e r e c ei v i n g o f a p p l ic a t i on

hrough courier / Pakistan Post etc.

Applications received on 12th September 2013 will not

be entertained by NTS

H el p l in e:

P h o n e N o . I S B : 0 5 1 - 92 5 8 4 78 - 7 9LHR: 042-99239258KHI: 021-35215013PES: 091-9218233

Website: www.nts.org.pkE-mail [email protected]

S en d Ap pl ic at io n F or ms t o:

M a n ag e r O p er a ti o n s

N a ti o n al T e st i ng S e r v ic e

9 6, S tr ee t N o. 4 , Se c to r H -8 /1 ,

Islamabad.


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Date:

O N L I N E D E P O S I T S L I P( * P l e a se d e po s it f e e i n o n ly o n e b a n k & t ic k t h e r e le v an t b a nk )

N a ti o n a l Te s t i ng S e r v i c eB u i l d i n g S t a n d a r ds i n E d u c a t io n a l a n d P r o f e s s i o n al Te s t i n g

Offi c e rCa shi e rCa shi e r

A/CNo.

I-8 Markaz Branch Islamabad (0140947)

NTS-P ak i st an-Col l e c t i on 0010008325640018

RemoteBranch:

A/CTitle:

(Formel y: A l l i ed B ank of P aki stan Li mi ted)

Allie dBa nk Limite d

A/CNo.

I-8 Markaz Branch, Islamabad ( 1501)

NTS-Col l e c t i on 0041749181000999

RemoteBranch:

A/CTitle:

Muslim Commercial Banku s l i m C o m m e r c i a l B a n k

Eight H u n d r ed R u p e e s O n l y.Non Ref undable/ Non Transf erable

A/CNo.

Cantt BrKashmir Road Rawalpindi (0041)

NT S- Pakistan 0205523391

RemoteBranch:

A/CTitle:

A/CNo.

H9 Shalimar Recording Co ISB (1742)

NT S-Collection 1742-79002786-03

RemoteBranch:

A/CTitle:

T H E P O W E R T O L E A D

LTD

STN STNN at i on a l T es t in g S e r v i ce

Building St andards in Educat ional and Prof essional Test ing

B ranch C ode:

B ranch Name:

Ca shi e rCa shi e rApplicant Signature

C N IC N o /B F o r m N o :

Fath erName:

Ap p lican tsName:

AmountRs:

Amou n t inword : Rs.

800/- Eight Hundr e d Rupees Only.Non Ref undable/ Non Transf erable

Not e: Bank Servi ce Charges F r e e o f C o st


STN STN

B ranch C ode:

B ranch Name:

Applicant Signature

C N IC N o /B F o r m N o :

Fath erName:

Ap p lican tsName:

Amou n tRs:

Amou n t inword : Rs.800/-

Date:

Offi c e r

Not e: Bank Servi ce Charges F r e e o f C o s t


A/CNo.

I-8 Markaz Branch Islamabad (0140947)

NTS-P ak i st an-Col l e c t i on 0010008325640018

RemoteBranch:

A/CTitle:

(Formel y: A l l i ed B ank of P aki stan Li mi ted)

Allie dBa nk Limite d

A/CNo.

I-8 Markaz Branch, Islamabad (1501)

NTS-Col l e c t i on 0041749181000999

RemoteBranch:

A/CTitle:

Muslim Commercial Banku s l i m C o m m e r c i a l B a n k

A/CNo.

Cantt BrKashmir Road Rawalpindi (0041)

NT S- Pakistan 0205523391

RemoteBranch:

A/CTitle:

A/CNo.

H9 Shalimar Recording Co ISB (1742)

NT S-Collection 1742-79002786-03

RemoteBranch:

A/CTitle:

T H E P O W E R T O L E A D

LTD





* N o t e : D e s i r e d B a n k S t a m p i s r e q u i re d o n t he D e p o s it S l i p & S e n d O r ig i n a lD e p o s i t S l i p (N T S C o p y ) a l o n g A p p l i c at i o n F o r m t o N T S O f f i c e

Ap p lic a tio n Fo r m will n o t b e e n te r ta in e d with o u t Or ig in a l De p o s it Slip ( NTS Co p y )a

* N o t e : 1 . P l e a s e S t a m p b o t h c o p i e s o f d e p o s i t S l i p .

2 . T h e B a n k M u s t R e t u r n N T S C o p y t o t h e C a n d i d a t e..3 D e p o s i t S l i p w i l l n o t a c c ep t e d w i t h o u t C a n d i d a t e C N I C / B F o r m N o .

bangladesh mbbs2014

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