Capital University of Science & Technology

Islamabad
MEDAL CLAIM FORM CONVOCATION 2016

Name: ____________________________

Registration No. _____________________________

Program:__________________________

CGPA:

_____________________________

Contact PTCL: ______________________

Mobile:

_____________________________

Batch No. _________________________

Please answer the following questions:
1.
a. Program start semester : _________________
b. Program end semester : _________________

Duration: ______________
(in years)

2. Number of F Grades in the duration of your program: __________________

3. Number of Credit Hours transferred to your program: __________________
4. Details of any disciplinary case/s against you during the duration of your program:

_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
5. Any other comments or remarks in support of your claim:

Note: Please see overleaf for Medal Award Policy