DR.

BALASAHEB SAWANT KONKAN KRISHI PHOTO

VIDYAPEETH,DAPOLI.
37th CONVOCATION

(Please read instructions carefully before filling the form)

To,
The Registrar,
Dr. Balasaheb Sawant Konkan
Krishi Vidyapeeth, Dapoli,
Dist. Ratnagiri.
Sir,
I wish to attend the convocation to receive my Degree of _________________
(Examination)
in person Rs.800/- Tick as
in absentia Rs.1000/-
My particulars are as follows :
Name in full (in block letters as per transcript issued by the university)

Sex Male Female Tick as

Addhar No.

Degree Examination PassingYear __________ (for example 2015-16)

Regd. No. _______ Name of College __________________________________________

Class awarded First Class with Distinction / First Class / Second Class

Post Graduate Degree Examination PassingYear __________ (for example 2015-16)

Regd. No. _______ Name of College __________________________________________
Discipline - ______________________________________________________________

Class awarded First Class with Distinction / First Class / Second Class

Doctoral Degree Examination PassingYear __________ (for example 2015-16)

Regd. No. _______ Name of College __________________________________________
Discipline -_______________________________________________________________

Class awarded First Distinction/First Division/Second Division/By Research

(Copy of transcript & Addhar Card compulsory enclosed)

[P.T.O.]

D:\Mydocuments\Worddata_2003\Convocation\37th CONVOCATION - Copy.doc 1

 I have read the notes overleaf and accordingly I have downloaded the e-receipt of

the prescribed fee of Rs. 1000/800 (One Thousand / Eight Hundred only) by vide e-

receipt. No. Dt._____________

Full Address for correspondence (Confirmation of Convocation date &

Degree Certificate will be sent on this address. Compulsory for all students.)

Name _____________________________________________________________

At.________________________________Post.____________________________

Tal._______________________________ Dist. ____________________________

State _______________________ Tel.No. ________________________________

Mobile No. ______________________ Email I.D. __________________________

Place __________________________ Date ______________________________

Candidate’s Signature

(Entries to be made by the University Office)

Result Checked by : Degree Certificate Checked by :

Challan Rs. _____________ Date _____________

Degree Certificate issued by in person /in absentia sent by post on _________________

Assistant Supdt. Dy. Registrar

INSTRUCTIONS

1. The fee for admission to the First / Second/Doctoral Degree of this University is
Rs. 1000/- (in absentia) and Rs. 800/- (in person). Candidates who seek admission to
more than one Degree at the same Convocation must submit a separate application and
pay separate fee in respect of each Degree.
2. The student should pay prescribed Convocation fee by online method on
www.dbskkv.org portal. The details of name of faculty should be invariably
mentioned on the back side of the e-receipt. No amount in form of Cash, IPO, DD will not
be accepted.
3. Incomplete forms, incomplete address,Phone No.s and those received after the expiry of
the prescribed date will not be considered.
4. Copy of Transcript & Adhar Card with the application form is compulsory.
5. Passport size photo & Adhar No. is compulsory for further verification of documents.

D:\Mydocuments\Worddata_2003\Convocation\37th CONVOCATION - Copy.doc 2

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