CENTRAL UNIVERSITY OF KASHMIR
Transit Campus: Sonwar, Srinagar – 190 004
A AP PP PL LI IC CA AT TI IO ON N F FO OR RM M F FO OR R P PR RO OV VI IS SI IO ON NA A L/ L /C CH HA AR RA AC CT TE ER R C CE ER RT TI IF FI IC CA A TE T E
Programme Programme Code Enrolment No.
Name
Parentage
Address for Correspondence / Dispatch of Certificate
________________________________________________________________________________________________________________________________________________________________
City/Town__________________________State/Province__________________________Postal Code__________________________
Phone No. __________________________ Mobile No. __________________________ e-mail id _____________________________
Particulars of the Last Examination Appeared (Passed/Failed)
S. No. Examination Year Marks Obtained Result Grade
Fee Details
(Please write your name & Enrolment No. at the back of the Demand Draft)
Draft No. Amount
Date Bank Payable at SRINAGAR
University Receipt No.
(Signature of the Applicant)
Received the Certificate mentioned above
Signature of the Candidate
I authorize ………. to collect my character/provisional certificate.
The specimen of the signature of the messenger is give below :
……… ………
Specimen Signature Signature of Candidate
FOR OFFICE USE ONLY
The above particulars have been verified by reference to the Register of the Students and found in order. As such, certificate may be sanctioned in favour of the applicant.
Dealing Assistant Section Officer
Certificate No. _______ dated ________________ issued and entered in Register of Students.
Dealing Assistant
Section Officer
Provisional/ Character Certificate Sanctioned
Section Officer Controller Examinations
Paste Recent Passport Size Colored Photograph
