Office of the Registrar,

Chulalongkorn
University

Application for certificates

/// ()

42

CR42

......................................
..........

......................................

.....
Mr./Miss/Mrs./other (specify)

...........

- () Name-family name (in

block...................................
letters)

Identification
...........................................................................................
Student ID

.....................

...................................
.....................

.........................................................................

............................................ E-mail address .

Faculty

Phone number

()
Requests
the following
documents
Be taken by the applicant
person authorized
(Fill in
the form of letter of authorization)

( 42/2)

Be given to the person authorized (Fill in the form of letter of authorization)

Items

Academic

(TRANSCRIPT)

Current
50

CR25

60

sealed envelopes not 50

60
sealed envelopes

50
sealed
envelopes not 50

60
sealed envelopes

60

50
Graduated / Terminated
sealed
envelopes
not

50

Graduated, pending the approval of the

sealed envelopes

23 60

Certificate of student status
50CR23

60

50

Certificate of student status (English

Certificate of conduct (English version)

50

50
24

50

()
50
Certificate of conduct (Thai version)
CR24
50
()
50
Other

Be given to the

Total

Number of

Amou

 ..................................................................................
Note
...............

..

/ .......
Signature of person

Date .......... / ........... /

............

Officers

...................................................
Verified

Corr
ect

Incorre
............................................................
ct

56022

Signat

Office of

Receipt

..
Receivers
......
Date .......... /
ID

Drivers
person
please produce:

Authorized
Government/enterprise

Other
/
ID card