DD-A

Indian Institute of Technology Kanpur

Office of the Dean, Academic Affairs

APPLICATION FOR CHANGE OF ACADEMIC PROGRAMME
From B.Tech to BT-MT or BS to BS-MS Dual Degree Programme


To,
The Chairman,
Senate Undergraduate Committee
IIT Kanpur

Sir,

I wish to change my academic programme from B.Tech./ BS to a Dual Degree Programme.
within the same discipline. My details are stated below:




1. Roll No.
2. Name of the Student
.
3. Department
.
4.
Dual Degree Programme
applied for:

BT-MT OR BS-MS
5. Current Semester (2013-14-II) is my 5
th
/ 6
th
....Semester
6. Have you availed any Semester Leave till date: Yes/ No
(If Yes, indicate Semester: ..)
7. CPI (at the end of 2013-14-I Semester): ...
8. Detail of backlogs: ...

The information furnished above is correct to the best of my knowledge.

..
Date:./../2014 Signature of the student
Hall No. .... Room No. .. Mobile No. ..


Recommendation of DUGC Convener: .
..
...
Signature of DUGC Convener


CHAIRMAN, SUGC