PP_________

PROVINCIAL ASSEMBLY OF THE PUNJAB

BIO-DATA OF THE MEMBERS OF THE ASSEMBLY

1. Name of the Member____________________________________________________

2. Father’s/husband’s name__________________________________________________

3. Date and place of birth___________________________________________________

4. Marital Status: Married Children Unmarried

5. Election Constituency____________________________________________________

6. Party affiliation_________________________________________________________

7. Profession_____________________________________________________________

8. Permanent Address______________________________________________________
______________________________________________________________________

Present Address_________________________________________________________
______________________________________________________________________
E-mail address__________________________________________________________

9. Phones Res:______________ Off:______________ Mobile__________________

Fax_____________________
10. National Identity Card No.________________________________________________
11. Educational Qualification:
S/N Degree/Certificate obtained Year of passing Name of Institution
(Starting with the most recent
and going backward)
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1. __________________________ ______________ __________________

2. __________________________ ______________ __________________
3. __________________________ ______________ __________________

4. __________________________ ______________ __________________

5. __________________________ ______________ __________________

6. __________________________ ______________ __________________

11. Previous representative positions held:

(a) In Local Government–

S/N Designation Institution Duration

1. __________________________ ______________ __________________

2. __________________________ ______________ __________________

3. __________________________ ______________ __________________

4. __________________________ ______________ __________________

5. __________________________ ______________ __________________

6. __________________________ ______________ __________________

(b) In Provincial Assembly–

S/N Designation Duration

1. ______________________________________ ____________________

2. ______________________________________ ____________________

3. ______________________________________ ____________________

4. ______________________________________ ____________________

5. ______________________________________ ____________________

6. ______________________________________ ____________________
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(c) In National Assembly–

S/N Designation Duration

1. ______________________________________ ____________________

2. ______________________________________ ____________________

3. ______________________________________ ____________________

4. ______________________________________ ____________________

5. ______________________________________ ____________________

6. ______________________________________ ____________________

(d) In Senate–

S/N Designation Duration

1. ______________________________________ ____________________

2. ______________________________________ ____________________

3. ______________________________________ ____________________

4. ______________________________________ ____________________

5. ______________________________________ ____________________

6. ______________________________________ ____________________

12. Detail of participation in National/International Conferences:

S/N Year Country Participated as

1. ___________________ _____________________ __________________
2. ___________________ _____________________ __________________
3. ___________________ _____________________ __________________
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13. Names of the relations in the present and previous National/Provincial Assemblies
and the Senate:

S/N Name of Member Name of Parliament Period Relationship

1. __________________ ________________ _____________ ____________

2. __________________ ________________ _____________ ____________

3. __________________ ________________ _____________ ____________

4. __________________ ________________ _____________ ____________

14. In case of former civil servant or ex-Defence Personnel, a Resume of his service career:

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

15. Additional information, if any–

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Dated _______________ ______________________________

Signature
of the Member
Provincial Assembly of the Punjab

Note: Please attach–

a) Eight colour passport size and eight stamp size (1” x 1”) recent photographs.
b) Two photo copies of Computerised National Identity Card.