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Student_Application_Form (6)

The document is an application format for students at Motilal Nehru National Institute of Technology Allahabad, detailing various requests such as attestation of documents, issuance of certificates, and fee refunds. It includes sections for student information, types of requests, and required documents for each request. The application must be submitted to the Dean (Academic) along with necessary enclosures and signatures.

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shockingwave7
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5 views

Student_Application_Form (6)

The document is an application format for students at Motilal Nehru National Institute of Technology Allahabad, detailing various requests such as attestation of documents, issuance of certificates, and fee refunds. It includes sections for student information, types of requests, and required documents for each request. The application must be submitted to the Dean (Academic) along with necessary enclosures and signatures.

Uploaded by

shockingwave7
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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vf/k"Bkrk ¼'kSf{kd½ dk;kZy; || Office of the Dean (Academic)

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Motilal Nehru National Institute of Technology Allahabad, Prayagraj – 211004, UP, INDIA

Format for Students Application


Date : ______/_______/_______
Student Name :
Registration Number :
Programme : B.Tech. / M.Tech. / MBA / MCA / M.Sc. / Ph.D.
Branch :
Semester :
Mobile Number :
Email :

Sl. No. Type of Request / Demands Please ( )


1. Request for attestation of academic documents

2. Request to issue Provisional Certificate


[Document(s) to be attached: fee receipt of ` 100 & NO DUES]
3. Request to issue Migration Certificate
[Document(s) to be attached: fee receipt of ` 200 & NO DUES]
4. Request to issue Transcript / Official Transcript
[Document(s) to be attached: all semester grade sheet, fee receipt of ` 500 (per set of 04 copies) (only for official
transcript) & NO DUES]
5. Request to issue Fee Receipt
[Document(s) to be attached: (i) Registration Fee Receipt & (ii) Category Certificate (for SC/ST & PwD) or
Income Certificate (if family income less than 05 Lakhs, for General & OBC Category students)
6. Request to issue Combined fee Statement
[Document(s) to be attached: registration slip and category certificate (if applicable)]
7. Request to issue fee Demand letter
[Document(s) to be attached: last semester registration slip and category certificate (if applicable)]
8. Request to issue No Objection Certificate for travel to native country for submission to
FRRO [for DASA/ ICCR/ MEA Students]
9. Request for fee refund (Please specify)
Beneficiary Name :
Beneficiary Address :
Actual Fee :
Excess Fee :
Type of Accommodation : Hosteller / Day-Scholar (Strikeout which is not applicable)
Bank Account No. :
Branch name and address :
IFSC :
10. Correction / Modification relating to Exam. / Grade / Transcript (Mention the case overleaf)

11. Any Other type Application: (Specify purpose below)

Signature of the applicant:………………………


OFFICE USE
Concerned Officers Please ( ) Signature
D.R. (Acad.) / A.R. (A&E) / F.I.(A) / F.I.(E)

P.T.O.

Page 1 of 2
To,
The Dean (Academic)
MNNIT Allahabad, Prayagraj

SUBJECT :

Respected Sir/Madam,

Yours sincerely

(Signature of the applicant with Name & Date)


Enclosure(s):
(1) (4)
(2) (5)
(3) (6)

Page 2 of 2

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