Application for Transcript / Bonafide cum Migration Certificate 1. Name :
For Office Use Only
Address:
Eligibility Verified (Yes/ NO)
Pin Code:
Signature
*Ph.(R)
*Mobile:
*Email ID:
2. Roll No:
3. Course Code:
4. No of Transcript copies requested
5. Bonafide cum Migration Certificate (Yes / No)
5. Briefly indicate the reason for obtaining the above certificate:
6. Academic Details (Enclose Xerox copy of the Marks Card of semesters):
Semester
Month & year of passing
Semester Total
Semester Grade
Remarks
7. Details of fees paid (Refer to the Instructions)
DD NO
DD Date
DD Amount(₹)
Bank Name: Demand Draft (DD) in favour of Sikkim Manipal University, payable at Gangtok Certified that information given above is correct. Processing time: 15 days from the date of receipt of application.
Place: Date:
Signature of the candidate 8. Applicant’s address to which the certificate to be sent
8. Checklist (put tick mark in appropriate box) 1) Xerox copies of all Marks Cards
Name: Address:
2) Demand Draft * Information is mandatory
Pin Code:
IMPORTANT INSTRUCTIONS Read the following instructions carefully before filling up the application form. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
S.No.1: Please write Name and Address, Phone Numbers and Email ID details. S.No.2: Write your Reg/Roll Number. S.No.3: Write the Course Code of the course you have completed. S.No.4: Write the number of additional copies of transcript required. S.No.5: Briefly indicate the purpose for which you require Transcript (compulsory). S.No.6: Please fill in the academic details in the table. S.No.7: Fill in the DD details. DD must be drawn in favour of Sikkim Manipal University, payable at Gangtok S.No.8: Checklist: Put the ‘tick’ mark in boxes as per enclosures list. S.No.9: Write the complete Address to which transcript to be dispatched. Enclose the following documents along with the application form: a) Duly attested by the Gazetted Officer or Notary Public - Xerox copy of the Marks card of all Semesters of program as mentioned at S.No.8 in the application form. b) Demand Draft.
(11) Fee Particulars
Category
Fee to be paid in ₹
1. Transcript
200 for first copy
2. Additional copies
100 per copy for Transcript only
3. Bonafide cum Migration
300 for each copy
4. Postage charges
1250 for Overseas only(Single Postage)
(12) Wire transfer details
Account No
007201019261
Account name
Sikkim Manipal University – DE
IFSC Code
ICIC0000072 ICICI Bank Manipal, Kasturba Hospital Complex, Main Road, Manipal, Udupi Pin - 576104, Karnataka
Address
(13) Please send duly filled application form along with enclosures to the following address for Transcript:
Office of Student Evaluation Sikkim Manipal University Directorate of Distance Education 5th Mile, Tadong, Gangtok, Sikkim - 737102, INDIA Tel: +91 - 3592 / 232041 Extension: 194 Email:
[email protected] (14) Email to
[email protected] for the transcript status.
