H-9, Islamabad (Pakistan)
Part 1: Applicant’s Details
1-1. Name of the Applicant (Dr. / Mr. / Ms.):
1-2. Status/Designition:
1-3. Department:
1-4. Institution:
1-4. Contact Details:
1-5. Cell:
Name & Designation of the Supervsior
1-6. Email:
Part 2: Research Details
2-1. Type of Research:

MS/M.Phil Thesis

Ph.D. Thesis

Faculty Research
2-2. Major Discipline:

Chemical Sciences

Bio-Sciences

Physical Sciences

Agricultural Sciences

Engineering

Other (please specify)
2-3. Has the research synopsis/proposal been approved by the competent forum (faculty board, research board, director research etc.) in university:

Yes

No
Part 3: Detail of the Sample Analysis
3-1. Details of Tests
SN Name of Test No. of Samples Rate per Test (Rs.) Total Cost (Rs.)
Total
Additional Information (if any) regarding sample tests/test methodology etc.may be provided on separate sheet.
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3-2. Name of the service provider institution where the test facility is available:
3-3. Any specific reason to get the samples analyzed from the above mentioned institution.
3-4. Consent of Service provider with test rates (please attach a copy).
Part 4: Declarations
4-1.
Declaration by the Researcher:
I hereby solemnly declare that the above mentioned test results will be used for academic/ research purpose only and the results will not be used for any commercial study or consultancy service.
________________________________
Signarure of the Applicant:
__________________________________
Countersigned by the Research Supervisor: (official stamp of research supervisor)
4-2.
Declaration by the Head of Department/Director ORIC:
I hereby solemnly declare that the above requested sample analyses facilities are not avaible in this university.
_________________________________________
Signature of the Head of Department/Diretcor ORIC (official stamp of HOD/Diretcor ORIC)
__________________________________________
Countersigned by Dean (official stamp of Dean)
Dated:
The following documenst need to be attached with the application form: i. One page summary of the research proposal, including the description of analysis need to be analyzed from from other institutions. ii. Consent of service provider showing rates of sample analysis.
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