Application Form For Award of Degree

NAGALAND UNIVERSITY
Headquarters : Lumami Campus : Kohima - 797 001
APPLICATION FORM FOR AWARD OF DEGREE IN PERSON / IN ABSENTIA
To
The Controller of Examinations,
Nagaland University,
H.Q. Lumami, Camp: Kohima
THROUGH THE PRINCIPAL / H.O.D…………………………………………………………..
……………………………………………………………………. (COLLEGE/DEPARTMENT)
Sir,
I shall be thankful if you could kindly award me Pass Certificate of………………………………..
………………………………………………………………………………………………………………..
(B.A / B.Sc / B.Com / B.Sc(Ag) / B.Ed / LL.B / MA / M.Sc / M.Com / M.Sc(Ag) / M.Phil / Ph.D)
IN ABSENTIA / IN PERSON, as I am unable to / I wish to attend the University Convocation for the
purpose. (Strike off which ever is not applicable and indicate Honours subject/Department clearly)
I am enclosing herewith attested photo copies of my mark sheet of the University examination passed,
Admit Card and University Registration Card for your reference.
1.
Full Name (as in the University
Registration Card) (in BLOCK
LETTERS)
2. Original Name (if applied for change
of Name) (in BLOCK LETTERS) : …………………………………………………………………
3. Sex : …………………………………………..........(Male / Female)
4. Date of Birth : …………………………………………………………………
5. Father’s Name : …………………………………………………………………
6. Registration No. with year : …………………………………………………………………
7. Roll number :
8. Year of Examination :
9. Division / Class in which passed : …………………………… Honours (if any): ……………......
10. Name of College / Department
from where Examination passed: : …………………………………………………………………
11. Address for correspondence : …………………………………………………………………
…………………………………………………………………
12. Instrument of fee paid : Demand Draft / Challan No. …………………………………
Date: ……………………… … Rs. ………………………..
Date: …………………………… ………………………………………
(Signature of the Applicant)
Certified that the above statement is verified with College / Department records and found correct.
Office Seal with Date ..………………………………………..
Seal and Signature of the
College Principal / H.O.D
(Stamp-signature will not be accepted)
Note: This application must be accompanied with a fee of Rs.150/ (in ABSENTIA) or Rs.100/- (in PERSON) drawn in favour of Nagaland University by Bank Draft or NU Challan.
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