Fjlall Ticket No:

CollegeCode*

VERSITY ANANTAPUR TAWNHNTAT NEHRU TECHNOLOGICAL LTNI

A,P. 5I5 OO2 ANANTAPTIR

for Awardof DEGREE/DIPLOMA Application

JNTUA, Anant To be sentto the Conholler of Examinations,

D.D.No.
Bank

Dt.
Amount Rs. Affix a recent Passport size Photograph.

T T T

(in Absentia) In Convocation I Pre-Convocation Post-Convocation I ) box) tfreappropriate ffl"t 1./1

Name In BlockLetters (asin SSC)

Father's Name (as in SSC)

Addressfor Communication (Do not repeatyoul name)

PinCode:

to be Degree/Diploma awarded

Degree/Diploma Branch

Name of the collegewhere last studied*

Month & Year of Passing

Month:

Year:

Place: Date: SIGNATURE OF TFIE CANDIDATE

ADDRESS LABELS (write in CAPITAL LETTERS ONLY) neatly and legibly' will be sentby post, write your full address your Degree/Diploma Note: As

Name: HTNo: S/o (or) D/o No.: House/Door

Name: HTNo: S/o (or) D/o No.: House/Door PIN: Street: Place: Dist.: Phone number: PIN:

Street:
Place:

Dist.:
number: Phone

Enclosures to the application:

1.

DD in favor of the Registrar,JNTUA, Anantapur payable at Anantapur. (HT Number shall be written on the back side of Demanddraft). Feesinclusive of Postage: a) b) c) In Convocation(In Absentia):Rs. 2000/Pre-Convocation: Rs. 3000/Post Convocation:Rs. 2000/- + Late fee ofRs. 500/- per eachyear

2.

PhotoCopy ofthe ProvisionalCertificate

(To be filled in by the Office of the Controllerof Examinations, JNTUA, Anantapur)

The

candidate has fulfilled

all

the

academic reouirements for .

the

award of

Degree / Diploma in

The candidate has

secured
Date:

class,

CONTROLLER OF EXAMINATIONS

(To be filled in by the Office of the Registrar,JNTUA, Anantapur)

l.

by the Academic Senateat its meeting The award of Degree/Diplomato the applicantwas endorsed heldon

L.

to the applicant at its meetingheld on 3. The ExecutiveCouncil approvedthe award of Degree/Diploma

4. Degree/Diploma bearingnumber Convocation heldon

5. Demanddraft enteredin the D.D. registerat pageNo. certificatemay be issued. 6. The Degree/Diploma

was awarded to the applicantat the

on

Date:

REGISTRAR

The Degree/ Diploma Certificate bearing No.

is disnatched on

Dispatching clerk, JNTUA, Anantapur