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Degree Form

This document contains an application form for candidates to apply for their postgraduate degree or diploma certificate from Maharashtra University of Health Sciences in Nashik, India. The form requires applicants to provide personal details like name, gender, address, contact information, as well as details of their college, course, and year of passing. It lists the mandatory documents to be enclosed and contains instructions for filling and submitting the form. It also provides information on collecting the certificate in person at convocation or later from the university.

Uploaded by

Kalyani Ingole
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© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
56 views

Degree Form

This document contains an application form for candidates to apply for their postgraduate degree or diploma certificate from Maharashtra University of Health Sciences in Nashik, India. The form requires applicants to provide personal details like name, gender, address, contact information, as well as details of their college, course, and year of passing. It lists the mandatory documents to be enclosed and contains instructions for filling and submitting the form. It also provides information on collecting the certificate in person at convocation or later from the university.

Uploaded by

Kalyani Ingole
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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MAHARASHTRA UNIVERSITY OF HEALTH SCIENCES, NASHIK
fnaMksjh jksM] EgljQG] ukf'kd&422004 Dindori Road, Mhasrul, Nashik-422004
Tel: 0253-2539250/251, Fax: 0253-2531836/2539260/222
Website: www.mush.ac.in

Application for PG Degree / PG Diploma Certificate. To be filled & submitted


by the successful candidate immediately after declaration of Final Year result.
(Before filling this form, please read the instructions given at the end. Fill up the Affix a photograph
of size 35mm
form in CAPTAL letters only) x45mm duly signed
across
To, & attested by
The Registrar, Dean/Principal of
Maharashtra University of Health Sciences, the Concerned
Nashik. college.

Mandatory Enclosures:-
(i) Attested photo copy of Passing Certificate (PG Degree / PG Diploma).
(ii) One additional photograph.
(iii) Attested photo copy of UG Degree Passing Certificate / UG Degree Marks Statement.

Sir,
I hereby apply for PG Degree / PG Diploma certificate of the University at the ensuing
convocation, to be held in the month of November / December / March /April, 20_______

PERSONAL DETAILS
1) Applicant’s Full Name in English (as per UG Degree Certificate) (one block Should be kept blank
between two words)

2) Name in Devnagri Script (Marathi):


3) Sex : (Male Female ) Phone No.: Mobile No :
4) Address for Correspondence

Pin Code
5) Name of College / Institute: .………………………………………………………………………
6) College Code: …………………. Month & Year of Passing final year: ………………………….
7) University Permanent Registration No. ……………………..... Seat No.: ……………………….
8) Convocation Attendance Status ( P – In Person, A – In Absentia )

DECLARATION BY THE CANDIDATE


I have carefully read & noted the Instructions, before filling in this form. I declare that
the information given above is true and correct to the best of my knowledge and belief. I undertake that I shall
be responsible for any omission / errors and wrong / incomplete entries made by me in this form.

Place:
Date : Signature of Applicant
INSTRUCTIONS TO THE APPLICANT

1) Incomplete forms and forms without attested photo copies of Final year passing Certificate, UG
Degree Passing certificate / UG Degree Marks Statement, will not be accepted.

2) The acknowledgement of this form should be preserved carefully and produced at the time of
collection of the PG Degree / PG Diploma Certificate on the day of the convocation, or as and
when the same is collected.

3) Any complaint, regarding non-receipt of PG Degree \ PG Diploma Certificate or correction in


Name, College, Class, Subject, Year of Passing, etc., will be entertained within a period of three
months from the date of the concerned convocation. No complaints will be entertained after the
Specified period.

4) Two identical visa type photograph (size 35mm X 45mm). Of which one duly attested by Dean
/ Principal of concerned college and should be pasted on the from at the space provided for it and
other photograph should be enclosed with application mentioning the course, name and
permanent registration Number on the reverse side. No photograph other than the stipulated size
i.e. 35mm X 45mm (Visa type) will be accepted.

5) Please check the details of convocation programme on University web site


<www.muhs.ac.in>, which will be notified one month in advance from the date of convocation
Ceremony.
6) Candidates are advised to collect his / her degree certificate within one year from the date of
convocation or else retention fee will be charged as per University rules prescribed from time to
time.

For Office use only


The applicant’s name, Academic and other details as stated in this application have been
checked with the office record and have been found correct/ incorrect. Acknowledgement/
observation letter issued vide letter No ----------------- dated ----------------------------------

In-charge Faculty

NAME & ADDRESS OF THE CANDIDATE


(to be filled in by the Candidate)
--------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------
---------------------- Tal.: ---------------- Dist.: -------------------------- Pin code.: ----------------------

ACKNOWLEDGEMENT SLIP
Convocation Application in respect of ------------------------------------------------------------------------
PRN----------------------------Course---------------------------has been duly received and found
correct in all respects. Degree will be issued in person to the student on production of this receipt
and photo identity, to the blood relatives (Father/Mother/Sister/Brother) of the student on
production of their photo identity and the authority letter issued by the concerned student on the
day of convocation or any working day after one month from the date of convocation.

In-charge Faculty

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