ApplicationForm Office of Exam - Upload - NEW

MAULANA AZAD NATIONAL INSTITUTE OF TECHNOLOGY, BHOPAL
Office of Examination
Office: 0755 4051030, 4051031, 4O51O32, Email: [email protected]
Application Form
For Office Use Ref no: Date of receiving: Sign. of official:
Nature of document required (Please √ whichever is applicable)

i Issue of Original degree vi Transcripts (Minimum five copies provided) )
ii Issue of Duplicate degree/Corrected degree vii Issue of Medium of Instruction Certificate
iii Issue of Migration/Transfer Certificate viii Conversion Certificate GGPA to % age
iv Issue of Duplicate Migration/Transfer Certificate ix Educational Document Verification
v Issue of Duplicate/Corrected mark sheets/ x Any other document related to exam,

grade sheet(s) please specify
*Students admitted from year 2017 onwards need not pay any fees for Original degree & Migration/Transfer Certificate
(as necessary fees had been already deposited at the time of admission).
However separate fees have to be paid for getting duplicate/ corrected documents of the same. Please pay requisite fees and
postal charges (as applicable) online through SBI collect or RTGS and send scanned copy of payment slip with final year mark sheet.
Link for fees submission https://www.onlinesbi.com/prelogin/icollecthome.htm
NAME of the Candidate in English (In capital letters as mentioned in mark sheet/grade sheet)
NAME MIDDILE NAME SURNAME
Name of the candidate in Hindi
Course (B. Tech/B.Arch/M Tech/ Mplan/ MCA/ Gender(Tick) M F

MBA/ /MUDP/ PhD)
AADHAAR No
Father’s Name
Mother’s Name
Address for correspondence/ Postal Address (Only If Degree/ Transcripts are required at postal address):
Pin Mobile
Code No.
E-mail ID
For S. no.(i)(ii)(iii)(iv)(vi)(vii)(viii) & (ix):
Division/SGPA/CGPA/GGPA Year of Scholar No
(students passed out) passing
I hereby undertake that I will maintain decorum and will strictly adhere to the convocation timings.
(For those who are willing to receive degree in convocation)
* For S. no. (v) & (vi):
*Year of Branch Examination last Month Year Result Enrolment no.

admission appeared/Passed
*Marks/SGPA/CGPA Semester 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th
obtained SGPA
CGPA
*Semester(s) of which duplicate Corrected Mark-

sheet/Grade sheet required
If collecting the documents personally Y/ N If No, whether “Authority Letter” in Y/N

prescribed format has been submitted
Note: Please ignore which is not applicable
Date______________ Yours Faithfully
Place______________ Name and Signature of Student/Applicant
Certificate to be recorded by Office of Examination
Certified that the eligibility for award of Degree Certificate/Migration/ Duplicate mark sheet/ Transcript/
Education verification/Any other desired relevant certificate has been checked with the original of concerned
Certificates, mark sheet, office of record of institution and found correct. Necessary documents along with
appropriate fees receipt is attached with the application form. The candidate may be issued the desired
relevant certificate.
Signature of Professor I/c Examination

Note:
Issue of Transcript/ Degree Certificate/Migration/ Duplicate mark sheet/ Education verification/ any other desired relevant certificate will
require minimum 14 working days from the date of submission of complete application with requisite fees, all enclosures and relevant
postal charges(if any).
Processing Fees, Postal charges and Other Enclosures required to be submitted along with the Application form
S.no. Document Enclousure(s) Processing Postal charges

Required Fees (as applicable if any)
1 Degree/ 1. Copy of final year self-attested mark sheet Degree fees http://www.manit.ac.in/sites/defa
Duplicate 2. FIR copy/ Police intimation copy for duplicate Rs. 1000/- ult/files/210219dvcoe.pdf
Degree/ degree Duplicate
Correction in 3. Original Affidavit by Notary on Rs.100 stamp degree fees
Degree(after paper for Duplicate Degree Rs. 1500/-
1 month of Correction in
convocation) Degree fees
Rs. 1500/-
2 Migration 1. Original final year Mark sheet to be brought at Migration fees Not to be posted
the time of collecting Migration/ Transfer Rs. 500/-
certificate Duplicate
2. Copy of the final year self-attested mark sheet migration fees
3. FIR/ Police intimation copy for duplicate Rs 1000/-
migration/Transfer certificate
4 Original Affidavit by Notary on Rs.100 stamp
paper for Duplicate migration/Transfer certificate
3 Transcripts 1.Self attested copy of mark sheets of all Rs 2000/- for http://www.manit.ac.in/sites/defa
semesters FIVE copies ult/files/210219dvcoe.pdf
2. Copy of degree
4 Duplicate 1. Original affidavit by Notary on Rs.100 stamp Rs. 500/- for http://www.manit.ac.in/sites/defa
mark sheet/ paper each mark- ult/files/210219dvcoe.pdf
grade sheet/ 2. Original Police intimation copy/FlR copy sheet/grade-
Correction or 3. Photocopy of required mark-sheet/grade- sheet.
changes in sheet Correction
per fees Rs. 500/-
Marksheet for each mark-
(after 1 sheet/grade-
month of sheet
print date)
5 Verification 1. Copy of final semester self-attested mark Rs. 1000/- per http://www.manit.ac.in/sites/defa
of student sheets and Copy of degree student ult/files/210219dvcoe.pdf
education
5 Medium of 1. Copy of final semester self-attested mark Rs. 500/-
Instruction sheets OR
Certificate 2.Copy of degree
6 Conversion 1. Copy of final semester self-attested mark Rs. 500/- By E-mail
Certificate sheets OR
GGPA to % 2.Copy of degree
age
Note:
*Students admitted from year 2017 onwards need not pay fees for Original degree & Migration/Transfer Certificate (as
necessary fees have been deposited at the time of admission). However separate fees have to be paid for getting duplicate/
corrected documents of the same.
*Please pay requisite fees and postal charges (as applicable) online through SBI collect or RTGS and send scanned copy of
payment slip with final year mark sheet. Link for fees submission: https://www.onlinesbi.com/prelogin/icollecthome.htm
*Issue of Transcript/ Degree Certificate/Migration/ Duplicate mark sheet/ Education verification/ any other desired relevant
certificate will require minimum 14 working days from the date of submission of complete application with requisite fees, all
enclosures and relevant postal charges(if any).
*Original Degree will only be handed over to student or his parents else it will be sent by post.
AUTHORITY LETTER
To
Professor In charge (Examination)

Office of Examination
MANIT
Bhopal
Subject: Regarding Authority Letter to collect document(s)
Dear Sir/Madam,
I {Name of the student/applicant} (Scholar No: ) hereby authorize {Name of the authorized
person } ( whose signature are attested below) to act as my representative and collect following
document(s)on my behalf from Office of Examination, MANIT Bhopal.
(Please √ whichever is applicable)
i Issue of Duplicate degree/Corrected degree v Transcripts

ii Issue of Migration/Transfer Certificate vi Issue of Medium of Instruction Certificate
iii Issue of Duplicate Migration/Transfer Certificate vii Conversion Certificate GGPA to % age
iv Issue of Duplicate/Corrected mark sheets/ viii Any other document related to exam,
grade sheet(s) please specify
Further, to state Mr/Ms.{Name of the authorized person } is my {mention your relationship with the authorized
person}. In this respect a copy of my identity proof and attested identity proof Mr/Ms.{Name of the authorized
person } is enclosed with the application for verification at your end.
_______________________________
Signature of the Authorized person
Thanking You
Date: Sincerely
Place:
Name & Sign.(Student/Applicant)
Enclosures:
a) Copy of Aadhar card of {Name of the Student/Applicant}

b) Copy of Aadhar card of {Name of the Authorized Person}
Note: Original Degree will only be handed over to student or his parents else it will be sent by post

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MAULANA AZAD NATIONAL INSTITUTE OF TECHNOLOGY, BHOPAL

For Office Use Ref no: Date of receiving: Sign. of official:

Nature of document required (Please √ whichever is applicable)

v Issue of Duplicate/Corrected mark sheets/ x Any other document related to exam,

NAME MIDDILE NAME SURNAME

Name of the candidate in Hindi

Course (B. Tech/B.Arch/M Tech/ Mplan/ MCA/ Gender(Tick) M F

* For S. no. (v) & (vi):

*Year of Branch Examination last Month Year Result Enrolment no.

*Semester(s) of which duplicate Corrected Mark-

If collecting the documents personally Y/ N If No, whether “Authority Letter” in Y/N

Note: Please ignore which is not applicable

Date______________ Yours Faithfully

Place______________ Name and Signature of Student/Applicant

Certificate to be recorded by Office of Examination

Signature of Professor I/c Examination

S.no. Document Enclousure(s) Processing Postal charges

Professor In charge (Examination)

Subject: Regarding Authority Letter to collect document(s)

i Issue of Duplicate degree/Corrected degree v Transcripts

a) Copy of Aadhar card of {Name of the Student/Applicant}

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