RAJASTHAN TECHNICAL UNIVERSITY

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Phone: +91-0744-2473014, 2473106, 2473063, 2473861
APPLICATION FOR
CONSOLIDATED MARKSHEET/PROVISIONAL DEGREE CERTIFICATE
(First Time)
COURSE: B.Tech. M.Tech. MBA MCA BHMCT B.Arch.

Roll No……………………………… Enrollment No……………………………….Branch……..…………

Name…………………………………………………………...……………………..…………………………..
Father’s Name…………………………………………………….……………………...…………………….
Mother’s Name………………………………………………………….………………..……………………
College……………………………………………………………………….………...…………………………
Choice For Delivery of Document (Please Tick  Mark) :- College Residence
Home Address :-…………………………..…………………………………………………………………...
………………………………………………………...…………………………………………………………..
…………………………………………………………………………………Pin Code……………………..
MARKS DETAIL
I II III IV V VI VII VIII IX X Grand
Sem. Sem. Sem. Sem. Sem. Sem. Sem. Sem. Sem. Sem. Total
Total Marks of
Papers Cleared in
Main/Reval
Total Marks of
Papers cleared in
Back
Semester Total
Check List :
1. Photocopy of All Semester (Main & Back) Marksheets Mobile No.
2. Photocopy of Enrollment Card E-Mail ID
3. Photocopy of Personal ID
4. Photocopy of Residence Proof (if delivered at residence)
5. One A4 size self addressed envelope Signature of Candidate with full name

Note :- 1. All attached photo copies of documents should be self attested and properly legible, otherwise
document(s) will not be prepared.
2. Internet mark sheets are not acceptable.
3. In case of any wrong information provided in the form, candidate will be fully responsible for the
same and University may take appropriate action against him.
For Office use only
Reference No. ……….……… Date……..……… Dispatch No……..………… Date……...……

Address :- Office of the Controller of Examination, Rajasthan Technical University, Rawatbhata Road,
Kota-324010