Hall Ticket No:

College Code *

JAWAHRLAL NEHRU TECHNOLOGICAL UNIVERSITY ANANTAPUR

ANANTAPUR 515 002 A.P.

Application for Award of DEGREE/DIPLOMA

(To be sent to the Controller of Examinations, JNTUA, Anantapur 515 002)

D.D.No. __________________ Bank _____________________ In Convocation (in Absentia) Pre-Convocation Post-Convocation

Dt.__________________ Amount Rs.___________

Affix a recent Passport size Photograph.

(Tick [] the appropriate box)

Name In Block Letters (as in SSC) Fathers Name (as in SSC)

Address for Communication (Do not repeat your name)

Pin Code: Degree/Diploma Branch

Degree/Diploma to be awarded

Name of the college where last studied*

Month & Year of Passing

Month:

Year:

Place: Date: SIGNATURE OF THE CANDIDATE

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

Staple one more Photograph here

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

PIN:

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

PIN:

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 Demand draft). Fees inclusive of Postage: a) b) c) 2. In Convocation (In Absentia): Rs. 2000/Pre-Convocation: Rs. 3000/Post Convocation: Rs. 2000/- + Late fee of Rs. 500/- per each year

Photo Copy of the Provisional Certificate

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

The

candidate

has

fulfilled

all

the

academic

requirements

for

the

award

of

__________________________ Degree / Diploma in _____________________. secured ____________________________ class.

The candidate has

Date:

CONTROLLER OF EXAMINATIONS

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

1. The award of Degree/Diploma to the applicant was endorsed by the Academic Senate at its meeting held on ____________________ 2. 3. The Executive Council approved the award of Degree/Diploma to the applicant at its meeting held on ____________________ 4. Degree/Diploma bearing number ______________________ was awarded to the applicant at the Convocation held on __________________________ 5. Demand draft entered in the D.D. register at page No. ________________ on _______________ 6. The Degree/Diploma certificate may be issued.

Date: REGISTRAR

The Degree / Diploma Certificate bearing No. __________________________is dispatched on __________________________

Dispatching clerk, JNTUA, Anantapur