Degree certificate request form

Place: Date: The Registrar, Attn: Student Services Department ICFAI University Rajawala Road, Central Hope Town, Selaqui, DEHRADUN -248197 UTTARAKHAND Phone: 0135-3003052 /3003022
Dear Sir, My current address where the certificate should be sent (Address should be written in CAPITAL Letters) Mr. (Name) _____________________________ _____________________________ _____________________________ _____________________________ PIN Code:

Ph. No.

Please send my Degree to the above address / I will collect my Degree in person. (Strike off whichever is not applicable) Yours sincerely (Signature) Name: ID No.: E-mail ID: Note: 1. Please write your full name and ID# on the back side of the D.D 2. Please enclose a photocopy of your photo I.D proof (Passport, PAN Card, Driving license, ICFAI ID etc., clearly showing your photograph). This is mandatory.