MADURAI KAMARAJ (To be filled in by the applicant)

UNIVERSITY
APPLICATION FORM FOR
OBTAINING DEGREE CERTIFICATE
(Those who have not applied for Regular
Convocations)
Note:
1. Candidates ae die!ted t" #" t$"%#$
t$e inst%!ti"ns !ae&%''( )e&"e
&i''in# t$e a**'i!ati"n &"+.
2. Defective applications will be e,e!ted.
lace :
Date : !ignature of the Candidate
("or #ffice $se #nly) (To be filled in by the applicant)
!.No: Dip. No: "ee Re%ittance articulars
Na%e !ection &nitial Na%e of the 'an(
)pplication lace
Na+e "& t$e De#ee -
S%),e!t -
Re#iste N%+)e -
Na+e -
Addess -
Pin-

*.Na%e of the degree passed: 'ranch + ,a-or
2. Na%e of the Candidate as entered in the $niversity records :
&N .N/0&!1 (C)&T)0)
&N T),&0
2. "ather3s na%e (,ention in Ta%il)
4. Na%e of the college and year of study:
,onth 5ear .6a% Reg. No. Degree Class .6a%. Centre
7. &f studied through DD. Course8 %ention
the .n. No. and year of ad%ission.
9. &f studied privately8 %ention the
.6e%ption order No. : date
;. 1as the candidate passed any %a-or sub-ect other than the sub-ect now applied8 if so furnish
the following details
Na%e of the Degree Na%e of the
$niversity
Reg. No. ,onth 5ear
<. !tate whether a copy of previous degree enclosed (lease refer instruction No.2)

Chec(ed by
Diplo%a
=ritten by
Chalan Date
Read by Draft No. : Date
.6a%ined by )%ount
Defects8 if any
lease write the Na%e and )ddress in the bo6 given below to which the degree certificate
to be sent.
* 2
Degree Reg.No. Degree Reg. No.
Na%e : Na%e :
)ddress: )ddress:
&NC#D.: &NC#D.:
,)D$R)& >),)R)? $N&@.R!&T5
INSTRUCTIONS TO T.E CANDIATE
)pplications with the reAuired fee and enclosures should be sent to the following address:
BT$e Re#ista Mad%ai Ka+aa, Uni/esit(0 Mad%ai 1 234 531C.
*. Dero6 copy of the provisional certificate8 final state%ent of %ar(s and course
co%pletion certificate (DD.) !1#$0D '. .NC0#!.D for which the
convocation application is %ade.
2. The convocation fee %ay be paid into the !tate 'an( of &ndia8 ,adurai or its
branches in !outhern region (i.e. in the states of Ta%ilnadu8 >arnata(a8 )ndhra8
>erala and ondicherry) to the credit of B,aduai >a%ara- $niversity E )ccount
No. * Chalan or de%and draft fro% any Nationalised ban(+ scheduled ban( drawn
in favour of the R./&!TR)R8 ,adurai >a%ara- $niversity8 ,adurai. The
Chalan + de%and draft should be sent along with the application. )pplication8
received without the chalan+ de%and draft will not be entertained. ,oney orders8
cheAues and Treasury Chalans will not be accepted.
2. Candidates who applied for the degrees li(e ,.hil. + ,.). + ,.!c. + ,.Co%. +
,..d. + '..d. + ,.0i.!c. + '.0i.!c. + ,.D. + ,.!. + ,... + ,.C.). + ,.!c. +
)pplied !cience + ,.'.). + ,.1.,. + ,.".C. + ,.0.,. + ,.'.,. + '.0itt. + '.0.
etc.8 should enclose an attested Dero6 copy of their previous basic degree
certificate (not provisional certificate) such as '.). + '.!c. + '.Co%. + '.'.). +
,.). + ,.!c. + ,.Co%. + '..d. + '.0i.!c. + ,.'.'.!. + '... + '.!c.+ )pplied
!cience + #T './.0. Candidates who have not obtained their basic degree are
not eligible to apply for the above such post /raduate degrees. )pplications
received without the Dero6 copy of the previous (basic) degree certificates will
su%%arily be re-ected.
4. Candidates who have studied and passed under the B0iberalised !che%eC ()ge
rule) of the Directorate of Distance .ducation of ,adurai >a%ara- $niversity
should enclose the Dero6 copy of the BCourse Co%pletion CertificateC
7. a) Candidates who have passed an additional branch in '.).+ '.!c. + ,.).+
,.!c.+ ,.'.).+ (other than whose already passed) need not apply for the
convocation. ,oreover8 they need not use this for%. ) separate application for%
%ay be obtained fro% the Registrar on reAuisition by such candidates.
b) Candidates Aualified for oriental title + certificate + diplo%a + ./. Diplo%a
courses %ay apply for the convocationF Candidate should enclose Dero6 copies
of the %ar( state%ent8 provisional certificate and $/ degree certificate along
with the application.
9. Candidates should not apply for two degrees at a ti%e.
;. .nAuiries fro% the candidates as to the receipt of the applications in the office
will not receive attention. Candidates are therefore advised to send the
applications by Registered post with ac(nowledge%ent due.
<. )pplication which is not properly filled in and which is received after the due
date will not be accepted. ,oreover the fees paid will not be refunded.
G. The fees for convocation under the special provision:
)ll $./.8 ./.8 rofessional courses8 h.D.8 and Certificate+Diplo%a Courses: Rs. 155567
)ll $./.8 ./.8 rofessional courses8 h.D.8 and Certificate+Diplo%a Courses D%*'i!ate-
Rs.30555+H
To obtain Duplicate Degree Certificate8 the Candidate is directed to send a
reAuisition along with the copies of the ,ar( !tate%ent + rovisional Certificate + Degree
Certificate with the following docu%ents.
*. )n affidavit sworn in by the candidate before the Notary ublic.
2. Certificate fro% the &nspector of olice stating that the Degree Certificate was
irrecoverably lost and not traceable. The copy of the receipt for the co%plaint
lodged in the olice !tation.
2. aper Notification evidence copy.