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APPLICATION FORM FOR ISSUE OF OFFICIAL TRANSCRIPT(S)
Name of the Programme B.TECH. / M.TECH. / MBA
Branch
Specialization (for PG programs only)
Hall Ticket Number
Name of the Candidate
(as in SSC, in capital letters)
Father’s Name (as in SSC, in capital letters)
Mother’s Name (as in SSC, in capital letters)
Candidate’s Mobile Number email ID:
Parent’s Mobile Number
Candidate’s Aadhaar Card Number
Full Address of candidate with PIN Code
(copy of address proof like Aadhaar Card / PAN
Card with photo ID is to be enclosed)
Details of Transcripts Required
i) Set of Grade Sheets:
Sl.
No.
Semester
Month & Year
(Regular ) Month & Year
(Supplementary) Month & Year
(Supplementary)
Month & Year
(Supplementary) Month & Year
(Supplementary)
1 I
2 II
3 III
4 IV
5 V
6 VI
7 VII
8 VIII
Total No. of Grade Sheets in a set (a) : ________________
No. of sets required (b) : ________________
ii) Transcript of Consolidated Grade Sheet : No. of copies required (c) : _______________________
iii) Transcript of Provisional Certificate : No. of copies required (d) : _____________________
Total No. of Transcripts = [(a×b) + c + d ] : ________________________
WES Reference Number : ___________________________ (Attach proof referring WES reference)
Amount to be paid for issue of Transcripts :
Category Time taken for issue of transcript Amount to be paid for each Transcript
General 7 working days (duration) 100/-
Tatkal 2 working days (duration) 500/-
Total amount paid towards issue of Transcripts = Total No. of Transcripts _____× Rs_____ = Rs. _______
Payment receipt / Transaction No. _____________, dt. ______________ (attach photocopy).
Place :
Date : Signature of Applicant
(PTO)
Category : General / Tatkal
WES
:
YES
/ NO
