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Certificatereleaseform KeMU ACA REG REC17 E2d3

The document is a Certificate and Academic Transcript Release Form for Kenya Methodist University. It requires students to provide personal details, confirm the return of academic attire, and ensure fees are cleared before issuing certificates and transcripts. Additionally, it includes sections for signatures from various offices and a section for collectors if different from the student.

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markkelvistah
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54 views1 page

Certificatereleaseform KeMU ACA REG REC17 E2d3

The document is a Certificate and Academic Transcript Release Form for Kenya Methodist University. It requires students to provide personal details, confirm the return of academic attire, and ensure fees are cleared before issuing certificates and transcripts. Additionally, it includes sections for signatures from various offices and a section for collectors if different from the student.

Uploaded by

markkelvistah
Copyright
© © All Rights Reserved
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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KeMU/REG/ACA/REC 17

KENYA METHODIST UNIVERSITY


P.O Box 267- 60200 – Meru, Kenya, Tel: +254-064-30301-31229, +254(0) 724256162
E-mail: [email protected] Website: www.kemu.ac.ke

CERTIFICATE AND ACADEMIC TRANSCRIPT RELEASE FORM


(To be filled in duplicate – one for student’s personal file, one for student that will be used to release the certificate)
1. STUDENT’S DETAILS (TO BE FILLED BY THE GRADUATE)

Reg. No.: __________________________________ Name: ______________________________

ID. No.: ___________________________________ Postal Address: _______________________


Tel. No.: _________________________Email Address: __________________________________
Programme (e.g. BEd) ___________________________Classification (e.g. 2nd Upper) _____________
Year of Graduation: _________________________________________________

2. REGISTRAR, ADMINISTRATION, PLANNING AND DEVELOPMENT


Academic Attire returned? YES NO NOT PICKED
Amount payable for Penalties/damages/loss: …………………………..………………

Name ………..…..……………………… Signature & Date (Stamp) …………………………………


3. CERTIFICATION OFFICE
Penalty for Picking Certificate & Transcript after Deadline: Months……... Amount payable…………

Name ………..…..……………………… Signature & Date (Stamp) …………………………………


4. STUDENTS FINANCE OFFICE
Confirmed that Fees has been Cleared? YES NO

Name ………..…..……………………… Signature & Date (Stamp) …………………………………


5. ISSUANCE OF CERTIFICATE AND ACADEMIC TRANSCRIPTS
a. I have collected my certificate YES NO
b. I have collected my academic transcripts YES NO
If not collected, my certificate / transcript need correction (state correction required and provide evidence where
applicable): ……………………………………………………………………………………………………
I certify that the above information is true to the best of my knowledge
Student’s signature: ______________________________ Date ________________
c. Collector’s details (if different from the student – attach letter of authorization and copies of ID –
Graduate’s and Collector’s)
Name: ______________________________________Relationship to student: _______________________
National ID: __________________________________ P.O Box: _________________________________
Telephone: _________________________________ Signature: __________________________________
d. FOR OFFICIAL USE
Certificate serial number: _____________________
Name of Issuing Officer ………..…..………………… Signature & Date (Stamp) …………………………………

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