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Bismillahir Rahmanir Rahim
APPLICATION FORM FOR EDUCATION
LOAN
Instructions:
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To be filled only by a person of Muslim Shia Ithna
Ashariyah faith, who is above 15 years of age and also a registered
Madh-hab Ahlulbayt member of M.A. Education Fund.
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To register yourself as a
Madh-hab Ahlulbayt Member, please fill in the
Madh-hab Ahlulbayt Membership Form,
before this Education Fund application form.
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Application for students of less than 15 years, should
be filled by their parents or guardians on his/her behalf.
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Read
the instructions,
General Guidelines and all clauses of this form carefully before
filling the form.
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Merely filling and submitting the form does not
necessarily mean that the application has been approved.
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Filling this form and signing it will automatically
bind the applicant with all the clauses in the General Guidelines in
full including clause no. E, F, and G in particular.
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Submit the duly filled form with 2 recent passport size
photos, all past school leaving certificates and results slips,
including joining instruction of the proposed school applied.
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You may
visit our Center to get the
Application form or you may print out this form and send to
our address by post after
filling it duly.
A - Details of the Parent /
Guardian if the Loan Applicant is less than 15 years of age.
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First Name
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Fathers Name |
Family Name |
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Date of Birth
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Place of Birth
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Nationality |
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P.O. Box
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Telephones
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Town/Country |
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Residential Plot No. |
Street:
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Area:
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Single / Married
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Work Occupation: |
B -
B- Details of
the Loan Applicant
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First Name
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Fathers Name |
Family Name
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Date of Birth
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Place of Birth
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Tribe / Nationality |
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P.O. Box
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Telephones
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Town/Country |
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Residential Plot No. |
Street:
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Area:
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Single / Married
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Work Occupation (if any):
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C - Education
History of the Applicant: Names and details of
Schools/Colleges/Madrassahs attended.
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School
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Name |
Town / Country |
Year: From / To |
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Primary School
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Secondary School
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High School
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College
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University
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Madrassah
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Madrassah
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Are you a Shia by birth or convert?
[ ] By Birth [ ] By Convert
in the year ...................... |
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Have you attended any Shia Madrassah?
[ ] Yes [ ] No
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Have you taken any Shia Correspondence Course?
[ ] Yes [ ] No
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How would you rate your knowledge about Shia Faith?
[ ] Nil [ ] Poor [ ]
Little [ ] Fair [ ] Good [
] Excellent
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D- Work and Job
History of the Applicant (if applicable):
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Type of Work
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Organisation |
Place of Work |
Year : From / To |
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1/
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2/
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3/
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E- Details of Family
Members, Parents, Guardians and Dependants:
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No |
Name |
Relation |
Date of Birth |
Education Level |
Religion/Sect |
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1
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2
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3
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4
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5
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6
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7
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8
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9
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10
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F- Details of the School and Course proposed to join:
1.
Name of the School/College
......................................................................................................
2. Address:
P.O. Box
...,,,.............................................................................................................
3. Type
of the Course:
................................................................................................................
4. Total
number of years of the entire course:
.................................................................................
5. When
does the course start (month/year)?
..................................................................................
6. Why
have you selected the above School?
...................................................................................
................................................
7.
Why have you selected the above course?
...................................................................................
.............................................................................................................................................
G - Details of Fees and other expenses of the Proposed Course:
1.
What is the fees payable per year?
.............................................................................................
2. What
is the total fees of the full course?
......................................................................................
3.
What are the other expenses required?
........................................................................................
............................................................................................................................................
4. How
much are you willing to pay by yourself?
................................................................................
5. How
much loan would you like to request from the Fund?
.................................................................
H - Repayment of the Loan
How would you like to repay the Loan if approved? Select at least two or
more of the following.
I.
[ ] To repay the loan in small
installments spread to a very long span of time, either repaid by the
student him/herself or his/her guardian.
II.
[ ] To repay through kind by
teaching, educating, and/or providing tuitions to his fellow students
for agreed time by both the parties.
III.
[ ] To repay through work for agreed time in institutions,
organizations, and/or companies as appointed by the M.A. Education
Fund.
IV. [
] To engage in Tabligh activities like preaching, lecturing, teaching,
translation work, humanitarian services, organizing tabligh programs,
etc.
________________________________________________________________________________________
Agreement:
I,
.............................................................................
hereby testify that I am a Muslim Shia Ithna Ashariyah by faith and
declare that the above details are correct to my full knowledge. By
signing this form, I have agreed to abide by all the rules of the MA
Education Fund Loan as stipulated in the General Guidelines.
Signed by the
Applicant:................................................
Date: ................................
Guarantors*:
1) Name:
............................................................... Address:
.......................................................
Signature
......................................................
2) Name:
.............................................................. Address:
........................................................
Signature .......................................................
* The Guarantors are
responsible to pay back the loan given, if the applicant fails to repay
it as agreed upon.
_________________________________________________________________________________________
For Official Use:
Loan approved / not approved
.................................................
Reason
................................................................................
Amount of Loan approved
.......................................................
Repayment method
................................................................
Other Conditions
...................................................................
Date:
..................................................................................
Signature:
...........................................................................
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