MALAVIYA NATIONAL INSTITUTE OF TECHNOLOGY JAIPUR

Application form
Nature of document required (Please √ whichever is applicable)
1) FOR STUDENTS STUDING IN MNIT JAIPUR
a) Issue of Original grade sheet Fee paid (if applicable) Rs._______________
b) Issue of medium of instruction certificate Receipt No.______________ Dt.______________
c) Issue of Bonafide Certificate Bank Draft No._______________ Dt.______________
d) Issue of Fee Structure Name of the Bank______________________________
e) Tuition fee certificate for claiming income tax deduction
f) Issue of C & S Form for foreign students
g) Issue of duplicate grade sheets
For Office Use
2) FOR PASS OUT STUDENTS
a) Transcripts (No. of copies- )
b) Verification of degree Diary No…………………..
c) Issue of duplicate degree Received on ………………
d) Issue of original degree Name & Signature of concerned
e) Issue of duplicate grade sheets officials ……………………
f) Issue of Migration Certificate ……………………………
g) Issue of Provisional Degree Certificate
h) If any other document, pl. specify …………………………………...

1. Name of the applicant :_______________________________ Student ID _____________________

2. Gender : MALE / FEMALE

3. Father’s Name : _______________________________

4. Mother’s Name : _______________________________

5. Name of the programme : B.Tech/B.Arch./M.Tech/M.Sc./MBA/Ph.D)

6. Branch//Discipline : _______________________________
7. Semester : _______________________________
8. Year of admission : _______________________________

9. Marks/SGPA/CGPA obtained:
Semester 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
SGPA

CGPA

10. Year of passing (in case of pass out students) : _______________________________

11. Reason for withdrawal (if applicable) : _______________________________
12. Name and Address for correspondence/ : _______________________________
dispatch of documents _______________________________
_______________________________

13. Contact details : Mobile No. _______________________________

: E-mail ID _______________________________

14. If collecting the documents personally : YES / NO

15. If not whether “Letter of Authority” in prescribed format submitted : YES / NO

Note: Please ignore which is not applicable

Signature of applicant
Date