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    Application For Application For Issuance of Provisional Pass Certificate Certificate

    Uploaded by

    Suman
    This document contains an application form for a student at Jadavpur University in Kolkata, India to request the issuance of a provisional pass certificate. The form requests information such as the student's name, course of study, year of passing, class/CGPA obtained, and contact details. It also includes a clearance report section for various university offices and departments to confirm the student has no outstanding dues. The notes at the bottom provide instructions that the application must be submitted within 7 days of results, a photocopy of the final grade card/marksheet must be enclosed, and the provisional certificate can be collected after 7 working days upon submission of payment.

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    Application For Application For Issuance of Provisional Pass Certificate Certificate

    Uploaded by

    Suman
    31 views1 page
    This document contains an application form for a student at Jadavpur University in Kolkata, India to request the issuance of a provisional pass certificate. The form requests information such as the student's name, course of study, year of passing, class/CGPA obtained, and contact details. It also includes a clearance report section for various university offices and departments to confirm the student has no outstanding dues. The notes at the bottom provide instructions that the application must be submitted within 7 days of results, a photocopy of the final grade card/marksheet must be enclosed, and the provisional certificate can be collected after 7 working days upon submission of payment.

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    Jadavpur

    Original Title

    1465448144-1

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    This document contains an application form for a student at Jadavpur University in Kolkata, India to request the issuance of a provisional pass certificate. The form requests information such as the student's name, course of study, year of passing, class/CGPA obtained, and contact details. It also includes a clearance report section for various university offices and departments to confirm the student has no outstanding dues. The notes at the bottom provide instructions that the application must be submitted within 7 days of results, a photocopy of the final grade card/marksheet must be enclosed, and the provisional certificate can be collected after 7 working days upon submission of payment.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    31 views1 page

    Application For Application For Issuance of Provisional Pass Certificate Certificate

    Uploaded by

    Suman
    This document contains an application form for a student at Jadavpur University in Kolkata, India to request the issuance of a provisional pass certificate. The form requests information such as the student's name, course of study, year of passing, class/CGPA obtained, and contact details. It also includes a clearance report section for various university offices and departments to confirm the student has no outstanding dues. The notes at the bottom provide instructions that the application must be submitted within 7 days of results, a photocopy of the final grade card/marksheet must be enclosed, and the provisional certificate can be collected after 7 working days upon submission of payment.

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    JADAVPUR UNIVERSITY

    KOLKATA – 700 032, INDIA


    Website : www. jaduniv.edu.in
    Phone : (033) 2457-2286, 2540

    APPLICATION FOR ISSUANCE OF PROVISIONAL PASS CERTIFICATE


    Particulars of the Applicant :
    Name (in CAPITAL LETTERS) :
    Course of Study Passed :
    Year of Passing : Exam. Roll No. of Final Sem. :
    Class Obtained : CGPA Obtained : Percentage of Marks Obtained :
    Whether already applied or will apply for Review of aforesaid Result (Yes / No) :
    Registration No. (with Session) : Class Roll No. :

    E-mail Address : Contact No. (Preferably


    Preferably a Mobile No.) :

    CLEARANCE REPORT :
    Sl. No. Section / Office / Department / School Report
    01 Muster Roll Section (Please report his / her dues)
    02 Dean of Students (Please confirm whether he / she is a hostel boarder)
    03 Hostel Supdt. (Please mention his / her dues, if he / she is a hostel boarder)
    04 Accounts Section (Please report his / her dues including hostel dues)
    Librarian (Please report i) his / her dues, if any
    05
    ii) whether he / she has returned all books)
    books

    I have enclosed photocopy


    hotocopy of Final Grade Card / Mark-sheet.
    Mark
    _______________________
    Date : Signature of the Candidate
    Provisional Pass Certificate may be / can not be issued

    _________________
    Assistant Registrar
    Nota bene :
     Fee for Provisional Certificate : 200/- for all U. G. & P. G. Courses including P. G. Diplomas from the session 2013 – 2014.
     Application for Provisional Certificate should be submitted within seven days of publication of result.
     Photocopy of Final Grade Card / Mark-sheet sheet in original, if issued, or downloaded copy of the same must be enclosed with the
    application.
     The application form for Provisional Certificate must be signed by the candidate.
     It may be collected by candidate or duly authorized person (whose (whose signature must be attested by the candidate in the letter of
    authorization addressed to the C.o.E.)) normally after SEVEN WORKING DAYS of duly submission of application, from the
    Examination Office, on submission of Money Receipt
    R against this application,
    pplication, Authorization Letter (if applicable) and photocopy of
    any authentic photo-identity
    identity of the candidate or authorized person (if relevant).
     It remains valid till date of the respective Convocation.

    For Use of Cash Section

    Received Two Hundred Only for Provisional Certificate.

    Scroll No.
    ____________
    Date : Cashier
    ashier

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