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This document contains an application form for a Post Graduate degree or diploma certificate from Maharashtra University of Health Sciences in Nashik, India. The form requests personal details of the applicant such as name, gender, address, phone number, college information and declaration of truth of the information provided. It also lists the mandatory documents to be enclosed and instructions for applicants, such as submitting the form after final year results and within 3 months of convocation.

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Samyukta Shekhar
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51 views2 pages

Convocationformpg

This document contains an application form for a Post Graduate degree or diploma certificate from Maharashtra University of Health Sciences in Nashik, India. The form requests personal details of the applicant such as name, gender, address, phone number, college information and declaration of truth of the information provided. It also lists the mandatory documents to be enclosed and instructions for applicants, such as submitting the form after final year results and within 3 months of convocation.

Uploaded by

Samyukta Shekhar
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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M AHA R AS HT RA U N IV ER SIT Y O F HEA L T H S CIE N CE S, N AS HIK

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Dindori Road, Mhasrul, Nashik-422004

Tel: 0253-2539250/251, Fax: 0253-2531836/2539260/222 Website: www.mushnashik.com

Application for PG Degree / PG Diploma Certificate To be filled in 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 form in CAPTAL letters only) To, The Registrar, Maharashtra University of Health Sciences, Nashik.

Affix a photograph of size 35mm x45mm duly signed across & attested by Dean/Principal of the Concerned college.

Mandatory Enclosures:(i) Attested Xerox copy of Passing Certificate (PG Degree / PG Diploma). (ii) One additional photograph. (iii) Attested Xerox 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 March / April,20_

PERSONAL DETAILS
1) Applications Full Name in English (as per UG Degree Certificate) (one block Should be kept blank after each name)

2) Name in Devnagri Script 3) Sex : (Male Female ) Phone No.: 4) Address for Correspondence

Mobile No :

5) 6) 7) 8)

Pin Code Name of College / Institute: . College Code: . Month & Year of Passing final year: . University Permanent Registration No. ..... Seat No.: . 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 Candidate

INSTRUCTION TO THE CANDIDATES


1) Incomplete forms and without attested Xerox 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 photography (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.muhsnashik.com>, which will be notified one month in advance from the date of convocation Ceremony.

For Office use only The applicants name, Academic and other detail as stated in this application have been checked with the office record and have been fund correct/ incorrect. Acknowledgement observation letter issued vide letter No ----------------- dated ---------------------------------In-charge Faculty NAME & ADDRESS OF THE CANDIDATES (to be filled in by the Candidate) ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Tal.: ---------------- Dist.: -------------------------- Pin code.: -------------------------

ACKNOWLEDGEMENT SLIP
Convection 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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