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National Institute of Technology Karnataka, Surathkal MANGALORE-575 025 Application For Transcripts

This document is an application form for transcripts from the National Institute of Technology Karnataka, Surathkal. It requests information such as the applicant's name, date of birth, sex, degree details, CGPA, fees paid, number of transcript sets required, delivery method, communication address, contact information and signature. It also provides fee details for transcript charges and postage costs within and outside of India.

Uploaded by

Prabhansh Pandey
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
64 views

National Institute of Technology Karnataka, Surathkal MANGALORE-575 025 Application For Transcripts

This document is an application form for transcripts from the National Institute of Technology Karnataka, Surathkal. It requests information such as the applicant's name, date of birth, sex, degree details, CGPA, fees paid, number of transcript sets required, delivery method, communication address, contact information and signature. It also provides fee details for transcript charges and postage costs within and outside of India.

Uploaded by

Prabhansh Pandey
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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NATIONAL INSTITUTE OF TECHNOLOGY KARNATAKA, SURATHKAL

MANGALORE- 575 025

APPLICATION FOR TRANSCRIPTS

1. Name of the Candidate : __________________________________________


(Block Letters) (As entered in institutional records in block letters)

2. Date of Birth :

3. Sex (Tick appropriate box) : Male Female

4. Details of the Degree


i) Degree : _____________________ ii) Branch : ______________________________
iii) Specialization : _________________________________________________________
(for P.G.)

iv) Roll No. : v) Year of Admission

v) Month & Year of passing :

5. Final CGPA obtained : _________________________________________________

6. Particulars of Fees paid :


Transaction Reference Number:___________________________________
Transaction Date: ________________________________________________
Amount: _________________________________________________________
Account details are as follows:
Institute Beneficiary Name: THE DIRECTOR, NITK SURATHKAL
Bank Name: STATE BANK OF INDIA, NITK campus Surathkal Branch
Account No. : 10175365060
Swift Code: SBININBB146
IFSC Code: SBIN0002273
(Send the screen shot of the transaction as a proof of payment to the email
id: [email protected])

7. Total Number of sets of Transcripts : ____________________________________


(For issue of Transcripts)
8. Mode of Delivery : By Post By Hand
(Tick appropriate box)
9. Name of the Institute / University : ________________________________________
(Mention any one University name you are applying for higher studies / job)
10. Communication address : _______________________________________________
(Block letters) _______________________________________________
(Transcripts will be sent to _______________________________________________
this address) _______________________________________________
Pin Code

11.Contact Number : __________________________


12.Email ID : __________________________
Place:
Date:
Signature of the Candidate
At the time of collection
By hand: Name & Signature: ____________________________
By Post: Dispatch Date : _________________________________
Fee Details:

Transcript Charge:
200/- per set

Postage charges:
Within India - 200/- (up to 10 copies)
- 500 /- (more than 10 copies)

Outside India - 50 Dollars (up to 10 copies) / 3000/-


- 100 Dollars (more than 10 copies) / 6000/-

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