PANJAB UNIVERSITY, CHANDIGARH
APPLICATION FOR ISSUANCE OF TRANSCRIPTS/VERIFICATION OF QUALIFICATION/ ATTESTATION OF PHOTO COPIES OF CERTIFICATES/ SYLLABI ETC. (TO BE FILLED IN STRICTLY BY THE CANDIDATE ONLY).

(SEE INSTRUCTION OVERLEAF)
                                                                                                                                                             B. Fee paid Rs. ______________________
                                                                                                                                                             Bank Draft/University
                                                                                                                                                             Receipt No. ________________________
                                                                                                                                                             (Name of the Bank)
                                                                                                                                                              Drawn on _________________________
                                                                                                                                                              Date _____________________________
A. APPLICANT;S NAME (PLEASE USE IN CAPITAL LETTERES ONLY)
               
         
B. FATHER’S NAME
               
         
C. MOTHER’S NAME
               
         
Regd. No.
C.      Nature of Document required (Please tick the relevant item) : Transcripts/ Verification of Qualifications/ Attestation  of  Photo copies of certificates/ Attestation of Photo copies of syllabi etc.
         No. of the copies for Transcripts/ Photocopies of Certificate/ Syllabi required : _______________________
D. Reason(s) for applying

E. Details of Examinations passed/Syllabi required :
Sr.No.  Name of Examination Roll No. Session/year Marks Obtd. Max. Marks Name of the College/Deptt./State
1            
2            
3            
4            
5            

F. Name, Full Address & Phone No. (if any) of the applicant:

Phone No.   Office    ______________Residence    _______________
E-mail Address  __________________________________________

____________________________
(Full Signature of the candidate)

G.                                                                                           (For Office use only)

Particulars checked and found correct.                                                                            

 Dealing Official/ Asstt./ A.S.O. 

Superintendent
H.   Names & Full address of the Institutions for dispatch of Transcripts/Verification of Qualifications/  Attested photo copies of certificates/Syllabi.
1.   _____________________________________________________
      _____________________________________________________
      _____________________________________________________		 3.________________________________________________________
_________________________________________________________
_________________________________________________________
2.   _____________________________________________________
      _____________________________________________________
      _____________________________________________________		 4.________________________________________________________
_________________________________________________________
_________________________________________________________