Reg. No. APPLICATION FORM To be Filled by NTS EPI HEALTH DEPARTMENT Picture 1 Paste your recent OF SINDH passport size color NTS photograph not older than 6 Months having Screening Test for the Post of blue background with gum Project ID: S-18-3393 Vaccinator (M/F) BPS-06 Eligibility Criteria: A. Is your age according to the prescribed age limit for the desired Post as on 15-02-2018? Yes No

B. Is your Qualification according to the requirements of the post? Yes No

C. Are you Domiciled in ? Yes No If your reply is “Yes” to A, B & C above, only then please proceed further. Otherwise you are not eligible to apply.

01. Bank Online Deposit of Rs: 325/- from Designated Bank Branches.

Bank Code Deposit Date

*Note: Application Form will not be entertained without Original Deposit Slip (NTS Copy)

Personal Information: Use CAPITAL letters and leave spaces between words. 02. Name in Full:

03. Father’s Name:

04. Candidate CNIC #: Write your own CNIC No. Or B Form No.

06. Date of Birth: D D M M Y Y 05. Gender: Male Female Write your Correct Date of Birth otherwise you will be rejected

07. Postal Address: All correspondence will be made on this address through courier service or ordinary postal service.

City: District:

08. Phone No: (OFF) (RES.) (Mobile) City Code - Phone No DO NOT give your portable mobile number (which is converted from one network to another) so that SMS delivery is ensured. 09. Are you a Government Servant and applying through proper channel? In case of Yes, please attach NOC Yes No If Non Muslim, 10. Religion: Muslim Non Muslim Please Specify:

11. Do you possess certificate of vaccination from recognized institute? Yes No If Any.

12. Academic Information: (Please do not attach copies of your academic certificates at this stage.) Note: 1. NTS will not issue Roll No Slips to those who have not filled in their academic record properly. 2. Result awaiting candidates are not eligible.

Certificate / Specialization / Year Degree / Sanad Title Board / University / Institute Degree Level Major Subject Passing Obtained Marks / CGPA Total Marks / CGPA

Science Matric / Matric O-Level Equivalent Arts (10 Years) Other: ______Other: ______

F.A A-Level Intermediate / Equivalent F.Sc (12 Years) Other: ______

Higher (If any) 15. Union Council / Town Applied For: Fill only 1 box situated as per your UC / Town, Multiple selection will lead to disqualification.

01. , District West List 02. , District Malir List 03. Town, District Malir, East, West List

West GULSHAN GHAZI-1 Malir IBRAHIM HAIDARY-1 Malir MEMON GOTH-1

West -2 Malir -2 Malir DARSANU CHANNU-2

West ISLAM NAGAR-3 Malir -3 Malir GADDAP-3

West NAYA ABADI-4 Malir QUAID ABAD-4 East GAJRU-4

West SAEED ABAD-5 Malir -5 West -5

West MUSLIM MUJAHID TOWN Malir GULSHAN HADID-6 West MUMAR ABAD-6

West MAHAJIR CAMP-7 Malir GHAGHR-7 West YOUSAF GOTH-7

West RASHEED ABAD-8 West MANGHO PEER-8 05. Gulshan-e-Iqbal Town, District East List

04. Gulberg Town, District East List East DEHLI MIRKAN TAIL-1 06. Jamshaid Town, District East List

East AZIZ ABAD-1 East PEHALWAN GOTH-10 East -1

East KAREEM ABAD-2 East METRO VIL-11 East JAMSHED QUATERS-10

East AYESHA MANZIL-3 East GULZAR HAJRI-12 East -11

East ANCHOLLI-4 East SAFORA-13 East SOLDIER BAZAR-12

East NASEER ABAD-5 East FAISAL CANTT-14 East QUATERS-13

East YASEEN ABAD-6 East CIVIC CENTER-2 East -2

East WATER PAMP-7 East PIB COLONY-3 East -4

East SHAFIQUE MIL-8 East -4 East MEHMOOD ABAD-5

East GULSHAN (1) -5 East PECHS(1)-6 07. Town, District Central List East GILLANI-6 East PECHS(2)-7 Central KALYANA-1 East DALMIA-7 East JAT LAND LINES-8 Central GULSHAN E MUSTAFA-10 East JAMALI COLONY-8 East JACOB LINES Central AJMAIR NAGRRI-11 East GULSHAN(2 0-9) Central GULSHAN E SAEED-12 09. Kemari Town, District West List

Central SHAHNAWAZ-13 08. North Town, District Central List West -1

Central SIR SYED-2 Central -1 West SULTAN ABAD-2

Central FATIMA JINNAH-3 Central BUFFER ZONE 1-10 West KEMARI-3

Central GODRAH-4 Central PAHAR GANJ-2 West BABA BHITT-4

Central HAKIM AHSAN-6 Central KHANDOH GOTH-3 West -5

Central MADINA COLONY-8 Central HAIDARI-4 West MARI PUR-6

Central FAISAL-8 Central -5 West -7

Central KHAMOSH GOTH-9 Central FAROOQ E AZAM-6 West GABO PAT-8

Central MUSTAFA ABAD-7

Central SHADMAN-8

Central BUFFER ZONE 2-9 10. Town, District Korangi List 11. , District Malir, Korangi List 12. Town, District South List

Korangi -1 Malir MUZAFFAR ABAD-1 South AGRA TAJ-1

Korangi BATHAI COLONY-10 Korangi BARMI COLONY-10 South -10

Korangi -2 Korangi KORANGI-11 South ALAMA IQBAL COLONY-11

Korangi -3 Korangi SHIABAD-12 South DARYA ABAD-2

Korangi SILVER TOWN-4 Malir MUSLIM ABAD-2 South NAYA ABAD-3

Korangi 100 QUATERS-5 Malir DAWOOD CHORANGI-3 South KADHA MEMON-4

Korangi -6 Malir MOMIN ABAD-4 South SHAH BAIG LINE-6

Korangi KORANGI(33)-7 Malir SHARAFI GOTH-5 South BAHAR COLONY-7

Korangi -8 Korangi BHUTTO NAGAR-6 South RANGI WARA-8

Korangi HASRAT MOHANI-9 Korangi LANDHII-8 South SINGO LINE

Korangi AWAMI COLONY-9 13. Town, District Central List 15. , District West List

Central -1 14. , District Malir, Korangi List West MOMIN ABAD-1

Central NAZIMABAD(1)-10 Malir MODEL COLONY-1 West GHABOOL COLONY-10

Central -11 Malir -2 West DATTA NAGAR-11

Central FIRDOS COLONY-2 Malir SAOOD ABAD-3 West MUJAHID ABAD-12

Central -3 Malir KHOKAR APAR-4 West -13

Central -4 Korangi JAFAR TAYYAR-5 West -2

Central QASIM ABAD-5 Korangi GHAREBABAD-6 West HANIF ABAD-3

Central HINDANI COLONY-6 Korangi GHAZI BAROHI-7 West MUHAMMAD NAGAR-4

Central SHARIF ABAD-7 Korangi MALIR CANTT-8 West MADINA COLONY-5

Central COMMERCIAL AREA-7 West GHAZI ABAD-6 17. , District Korangi List Central -9 West CHISHTI NAGAR-7 Korangi -1 West BILAL COLONY-8 16. Town, District South List Korangi SADDAT COLONY-2 West ISLAM CHOWK-9 South OLD HAJI CAMP-1 Korangi DRIG COLONY-3

South CALIFTON-10 Korangi RETA PLOT-4 18. Site Town, District West List

South KHAKSHAN-11 Korangi MORIA KHAN-5 West PAK COLONY-1

South GARDEN-2 Korangi RAFA-AAM-6 West OLD GOLLI MAAR-2

South KHARRADAR-3 Korangi ALFALAH-7 West -3

South -5 Korangi DRIG ROAD/AIR PORT West METRO VIL-4

South GAZDRABAD-6 Korangi PEF-8 West BOWANNI CHALI-5

South -7 West -6

South SADDAR-8 West -7

South CIVIL LINES-9 West -8

South KARACHI CANTT West -9

South CCB-3

South CCB-4

South CCB-1 Undertaking By The Applicant: I______d/s/w of ______do hereby solemnly declare and affirm that I have read and understood the instructions and conditions for appearing in Picture 2 the NTS Test, and I have filled-up the application form as per instructions given below. In case of Affix your recent any information contained herein is found at any stage to be missing, untrue, false or forged, my passport size color candidature can be cancelled at any stage (even after employment, if so revealed later), and I shall photograph not older than be liable to legal action. 6 Months having blue background with Stapler

Date: ______Thumb Impression ______Candidate’s Signature ______General Instructions / Information: Ø Please fill the Application Form properly with complete and correct information / answers. Ø Please DO NOT leave any field blank, otherwise your application may not be considered. Ø Incorrect, false or forged information may result in cancellation of your candidature at any stage, even after employment, and also proceeding of a legal action. Ø Attach your Two recent Passport Size Photographs, Copy of CNIC and Original Bank Deposit Slip (NTS Copy) Ø By Hand submission of Application Form is not allowed. Ø Mobile Phones or any Electronic Gadgets are not allowed in Test Center premises. Ø Use separate envelope and separate application form for each post you are applying for. Ø Last date for submission of application form is Thursday 15th February, 2018. Please Send Application Forms to: HELP LINE: NATIONAL TESTING SERVICE UAN : +92-51-844-444-1 Website : www.nts.org.pk EPI Sindh (Project) Plot 96, Street No. 4, Sector H-8/1, Islamabad. Keep Visiting NTS Website Building Standards in Educational and Professional Testing Building Standards in Educational and Professional Testing NTS COPY BANK COPY EPI HEALTH DEPARTMENT OF SINDH KARACHI EPI HEALTH DEPARTMENT OF SINDH KARACHI

Branch Code: Date: Branch Code: Date:

Branch Name: Branch Name: O N L I N E D E P O S I T S L I P O N L I N E D E P O S I T S L I P (* Please deposit fee in only one bank & tick the relevant bank) (* Please deposit fee in only one bank & tick the relevant bank)

Allied Bank Limited Allied Bank Limited Formely: Allied Bank of Pakistan Limited Muslim Commercial Bank Formely: Allied Bank of Pakistan Limited Muslim Commercial Bank

A/C Title: NTS-Pakistan-Collection A/C Title: NTS-Pakistan A/C Title: NTS-Pakistan-Collection A/C Title: NTS-Pakistan

A/C No: 0010008325640018 A/C No: 0647943831005734 A/C No: 0010008325640018 A/C No: 0647943831005734 Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost

A/C Title: National Testing Service-Pakistan A/C Title: NTS Pakistan A/C Title: National Testing Service-Pakistan A/C Title: NTS Pakistan

A/C No: 0101820001 A/C No: 00427991771403 A/C No: 0101820001 A/C No: 00427991771403 Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost

*Note: Desired Bank Stamp is required on the Deposit Slip & Send Original Deposit *Note: Slip (NTS Copy) along Application Form to NTS Office 1. Please Stamp both copies of deposit Slip. a 2. The Bank Must Return “NTS Copy” to the Candidate. Application Form will not be entertained without Original Deposit Slip (NTS Copy) 3. Deposit Slip will not accepted without Candidate CNIC/ B Form No.

Project ID: S-18-3393 Project ID: S-18-3393

Applicant’s Applicant’s Name: Name: Father Father Name: Name: CNIC No/ CNIC No/ B Form No: B Form No:

Post Name: Post Name:

GST INVOICE GST INVOICE NTN # 2680612-6 NTN # 2680612-6 GST # 3277876121192 GST # 3277876121192

NTS fee: 288/- NTS fee: 288/- Amount in Three Hundred & Twenty Five Rupees Amount in Three Hundred & Twenty Five Rupees GST@ 13%: 37/- GST@ 13%: 37/- word: Rs. Non Refundable/ Non Transferable word: Rs. Non Refundable/ Non Transferable Total: 325/- Total: 325/-

Applicant Signature Cashier Officer Applicant Signature Cashier Officer

Building Standards in Educational and Professional Testing CANDIDATE COPY EPI HEALTH DEPARTMENT OF SINDH KARACHI

Branch Code: Branch Name: Date: O N L I N E D E P O S I T S L I P (* Please deposit fee in only one bank & tick the relevant bank) Allied Bank Limited Formely: Allied Bank of Pakistan Limited Muslim Commercial Bank

A/C Title: NTS-Pakistan-Collection A/C Title: NTS-Pakistan A/C Title: National Testing Service-Pakistan A/C Title: NTS Pakistan

A/C No: 0010008325640018 A/C No: 0647943831005734 A/C No: 0101820001 A/C No: 00427991771403 Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost Note: Bank Service Charges Free of Cost

*Note: Desired Bank Stamp is required on the Deposit Slip & Send Original Deposit Slip (NTS Copy) along Application Form to NTS Office. Application Form will not be entertained without Original Deposit Slip (NTS Copy)

Project ID: S-18-3393

Applicant’s Father Name: Name: CNIC No/ Post Name: B Form No: GST INVOICE NTS fee: 288/- Amount in Three Hundred & Twenty Five Rupees NTN # 2680612-6 GST@ 13%: 37/- word: Rs. Non Refundable/ Non Transferable GST # 3277876121192 Total: 325/-

Applicant Signature Cashier Officer