Application Form for Degree in Absentia

Transcription

Application Form for Degree in Absentia
HIMACHAL PRADESH UNIVERSITY
GYANPATH, SUMMER HILL, SHIMLA-171005
[For details of fee updates visit www.hpuniv.nic.in & www.hpuniv.in]
Application form for Degree in Absentia
To
The Controller of Examinations,
Himachal Pradesh University,
Shimla-171005
Sir,
I intend to take my degree of ___________________ in absentia and I request that I
may be admitted to the same. I am sending herewith IPOs/Bank Draft worth Rs. 500/- in cash
with the University Cashier vide receipt No. ____________ dated__________ IPOs/Bank
Draft worth Rs. ______________ in favour of Finance Officer, H.P. University, Summer
Hill, Shimla- 171 005.
(Signature of Applicant)
Particulars to be filled in by the Applicant
1. Name of the Applicant (English)__________________________________________
(Hindi)______________________________________________________________
2. Father’s Name (English) ________________________________________________
(Hindi) ______________________________________________________________
3. Enrolment No. ________________________________________________________
4. University Roll No.____________________________________________________
5. Examination Passed Year/Session_________________________________________
6. Examination Centre (Last Appeared)_______________________________________
7. Marks Obtained Division________________________________________________
8. Subjects_____________________________________________________________
9. Permanent Address____________________________________________________
10. Correspondence Address________________________________________________
(Signature of the Applicant)
Head of Deptt./Dean Concerned
Director of ICDEOL
(office seal) H.P. University, Shimla
(Not Applicable to Private Candidates)

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