Degreecertificate

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North-Eastern Hill University

NEHU Campus, Shillong – 793022 (Meghalaya)

HEAD QUARTERS: SHILLONG – 793022


APPLICATION FOR DEGREE CERTIFICATE

1. Name of the Degree Applied for:

…………………………………………………………………………………………………

2. Mention Pass or Honours, with Class, Division and Subjects etc:

…………………………………………………………………………………………………

3. Name of the Candidate (in block letters):

………………………………………………………………………………………………....

4. Registration No

…………………………………………………………………………………………………

5. Father’s Name:

………………………………………………………………………………………………….

6. Roll No: ……………………………... year of Passing: ………………………………………

7. Name of the College/ Department

………………………………………………………………………………………………….

8. Complete Address for Correspondence, with contact Number if any:

………………………………………………………………………………………………….

………………………………………………………………………………………………….

…………………………………………………………………………….................................

…………………………………………………………………………………….....................

9. Number & Date of the payment of prescribed fee

………………………………………………………………………………………………….
Countersigned by:
Principal or Head of the Department
(With Office Seal)

Station: ………………………………

Date: …………………………………

Note: The prescribed fee for the Certificate is Rs.500/- (Rupees Five Hundred) only, Payment be made
by going to this website https://www.onlinesbi.com/ and then click on State Bank
Collect.

N.B.: The Candidate should submit an attested Mark Sheet and Xerox copy of Registration Card along
with the Application Form.

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