giet university...giet university gunupur, odisha – 765022 form no: a 03 application for back...

GIET UNIVERSITY

GUNUPUR, ODISHA – 765022

Form No: A 01

APPLICATION FOR SEMESTER REGISTRATION / SUBJECT REGISTRATION

Instructions:

(i) Application shall be forwarded by the Dean / HOD of the respective department.

(ii) Fees as per Academic Regulation for B. Tech / M. Tech / M. A / M. Sc / M.B.A / M.C.A / B.B.A /

B. Sc (Ag) / Ph. D.

A. Name of the Student :

B. Registration Number :

C. Roll Number :

D Programme - Branch :

E Semester :

F. Mobile :

G. Email id. :

Subject Registration

Sl.No. Subject Code Subject Name Semester

1

2

3

4

5

6

7

8

9

10

G. Mode of Payment:

College Dues (Tuition Fees & Hostel Fees)

Registration Fees

Without Fine

Registration Fees

With Fine

Rs.500/-

Registration Fees

With Fine

Rs.1000/-

Registration Fees

With Fine

Rs.2000/-

Total

Amount

(i) Receipt No: ............................ Date: ............................

Signature of Student Signature of HOD / Dean

GIET UNIVERSITY


Form No: A 02

APPLICATION FOR RE-EVALUATION / RE-EVALUATION WITH PHOTOCOPY

Instructions:

(i) Application shall be forwarded by the Dean / HOD of the respective department.

(ii) Fees of Rs.300/- (for Re-evaluation) and Rs.1000/- (for Re-evaluation with photocopy) for each subject in shape of Cash is to be deposited in the respective department.



C. Roll Number :


E Semester :

F. Mobile :

G. Email id. :


Sl.No. Subject Code Subject Name Mode of apply

1

2

3

4

5

6

7

8

9

10

E. Mode of Payment:

(i) Cash: Rs............................. (Rupees ____________________________________ )

(ii) Receipt No :

(iii) Date :


GIET UNIVERSITY


Form No: A 03

APPLICATION FOR BACK PAPER SUBJECT REGISTRATION

Instructions: (i) Application shall be forwarded by the Dean / HOD of the respective department. (ii) Fees of Rs.300/- for each subject in shape of Cash are to be deposited in the respective department.



C. Roll Number :


E Semester :

F. Mobile :

G. Email id. :


Sl.No. Subject Code Subject Name Semester

1

2

3

4

5

6

7

8

9

10

E. Mode of Payment:

(i) Cash: Rs. ............................ ( Rupees ___________________________________ )

(ii) Receipt No :

(iii) Date :


GIET UNIVERSITY


Form No: A 04

APPLICATION FOR CHALLENGING EVALUATION

Instructions: (i) Application shall be forwarded by the Dean / HOD of the respective department.

(ii) Fees of Rs.5000/- for each subject in shape of Cash is to be deposited in the

respective department.



C. Roll Number :


E Semester :

F. Mobile :

G. Email id. :


Sl.No. Subject Code Subject Name Mode of apply

1

2

3

4

5

6

7

8

9

10

E. Mode of Payment:

(i) Cash: Rs. ........................... ( Rupees ____________________________________ )

(ii) Receipt No. :

(iii) Date :


GIET UNIVERSITY


Form No: A 05

APPLICATION FOR ADDITIONAL GRADE SHEETS / TRANSCRIPTS

Instructions:

(i) Application shall be forwarded by the Dean / HoD of the respective department specifying the reason / purpose for additional Grade Sheets / Transcripts.

(ii) Grade Sheets / Additional Grade Sheets / Transcripts are issued year-wise (iii) Purpose of Additional Grade Sheet / Transcript has to be enclosed with the application form

(advertisement of the University to which the candidate is applying must be attached) (iv) Fees of Rs.100/- (per year per each Grade Sheet) / Fees of Rs. 400/- (per Transcript). Accordingly

the amount will be paid and the Transaction Slip is to be attached with the form.

Note: Attested copies of Grade Sheet (s) and Degree Certificate is to be attached with the form forwarded by the Dean / HoD.

(THE TESTIMONIAL WILL BE ISSUED AFTER 15 WORKING DAYS ON RECEIPT OF THIS FORM)



C. Roll Number :


E Mobile :

F. Email id. :

G. No. of Additional Grade

Sheets Required

:

Transcripts required: Tick (√ ) the Appropriate Box

1st Year 2nd Year 3rd Year 4th Year

H. Online Payment Details

(a) Amount: Rs. …………………… (Rupees ______________________________ )

(b) Transaction ID/Receipt No.:

(c) Date of payment :

(d) Transaction receipt attached: YES / No

Date : Signature of Student

Signature of HOD / Dean Signature of the Registrar (with Seal)

GIET UNIVERSITY


Form No: A 06

APPLICATION FOR MIGRATION CERTIFICATE

Instructions:

(i) NOC from the HOD of the concerned department to be enclosed with application form.

(ii) Application shall be forwarded by the Dean / HOD of the respective department specifying the

reason/ purpose for issuance of the Certificate.

(iii) Fees of Rs. 200/- is to be paid and the Transaction Slip is to be attached with the form.

(THE TESTIMONIAL WILL BE ISSUED AFTER 07 WORKING DAYS ON RECEIPT OF THIS FORM)



C. Roll Number :


E Reason / Purpose :

F. Mobile :

G. Email id. :

H. Online Payment Details

(a) Amount : Rs. ………………( Rupees_____________________________________________)

(b) Transaction ID :


(d) Transaction receipt attached :

Date: …………………………. Signature of Student

Signature of the Registrar (with Seal)

GIET UNIVERSITY


Form No: A 07

APPLICATION FOR CORRECTION OF NAME IN GRADE SHEETS / DEGREE CERTIFICATE

Instructions:

(i) Application shall be forwarded by the Dean / HOD of the respective department specifying the

corrected name.

(ii) The application shall be enclosed with the attested copies of the HSC and CHSC certificate.

(iii) Original Degree Certificate with Wrong Name.

(iv) Fees of Rs.100/- (for correction of name in grade sheet) / Rs.200/- (for correction of name in

degree certificate) to be paid and transaction slip is to be attached with this form.

A. Registration Number Name of the Student

:

B. Programme - Branch :

C. Roll Number :

D Wrong Name as Printed

:

E Correct Name to be Printed

:

F. Mobile :

G. Email id. :

H. Payment Details

(a) Amount : Rs. ………………(Rupees_________________________________________ )



(d) Transaction receipt attached : YES / NO

Date: …………………………. Signature of Student

Signature of HOD / Dean Signature of the Registrar (with Seal)

GIET UNIVERSITY


Form No: A 08

APPLICATION FOR BRANCH CHANGE

Instructions: Refer to Clause No.____ of Academic Regulation (R-19) for B. Tech



C. Roll Number :

D. Result : I Semester SGPA II Semester SGPA CGPA

D Programme – Branch

at the time of

admission

:

E New Branch applied :

F. Mobile :

G. Email id. :

Date : Signature of Student

Signature of the Registrar

(with Seal)

GIET UNIVERSITY


Form No: A 09

APPLICATION FOR DUPLICATE GRADE SHEETS

Instructions:

(i) Application shall be forwarded by the Dean / HOD of the respective department specifying the reason for Duplicate Grade Sheets.

(ii) Grade sheets are issued year – wise. (iii) Fees of Rs.100/- per year per each Grade Sheet. Accordingly the amount will be paid and the

Transaction Slip is to be attached with the form.



C. Roll Number :

D Programme – Branch :

E Mobile :

F. Email id. :

Tick (√ ) in the Appropriate Box for Duplicate grade sheets

I Year II Year III Year IV Year

G. Payment Details





`

Date : ………………………… Signature of Student

Signature of HOD / Dean Signature of the Registrar

(with Seal)

GIET UNIVERSITY


Form No: A 10

APPLICATION FOR DUPLICATE DEGREE CERTIFICATE

Instructions:

(i) Application shall be forwarded by the Dean / HOD of the respective department specifying the reason for Duplicate Degree Certificate.

(ii) The application shall be accompanied by the Original FIR of Police Station where the degree certificate has lost / damaged.

(iii) Original Affidavit swearing before First Class Magistrate. (iv) Original clipping of the News Paper (at least in 2) of Orissa State in which loss / damage so

published. (v) Fees of Rs. 500/- to be paid and the Transaction Slip is to be attached with the form.



C. Programme – Branch :

D Issuance date of Degree :

E Mobile Number :

F. Email id. :

H. Payment Details





Date : ………………………… Signature of Student

Signature of HOD / Dean Signature of the Registrar

(with Seal)

giet university...giet university gunupur, odisha – 765022 form no: a 03 application for back...

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