Application Form for Grace Mark

Name:

Roll No.:

Event/Events:

Event Code:

Prize Obtained:

Eligible Grace Marks:

Recommendation from the Co-ordinator of the Event

This is to certify that the above student has participated in the Inter-University/South
Zone/National/International competitions in _________________________________ and won
1st/2nd/3rd prize.

Name and signature of the event co ordinator.

Note: Copy of the Certificates obtained and a copy of the student’s admit card to be attached
along with this application.

All applications to be reached in the exam department on or before 30-11-2016.