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Provisional Certificate Application Form

1. The document is an application form for students of SRI KRISHNADEVARAYA UNIVERSITY to apply for a provisional certificate or provisional certificate cum consolidated marks memo for their Bachelors degree. 2. It requests information such as the applicant's name, register number, degree course details, period of study, subjects studied, address and payment details. 3. The notes at the bottom provide instructions for applicants such as sending the application to the Dean of UG Examinations along with the required documents and payment.

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Kotha Thirupal
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952 views2 pages

Provisional Certificate Application Form

1. The document is an application form for students of SRI KRISHNADEVARAYA UNIVERSITY to apply for a provisional certificate or provisional certificate cum consolidated marks memo for their Bachelors degree. 2. It requests information such as the applicant's name, register number, degree course details, period of study, subjects studied, address and payment details. 3. The notes at the bottom provide instructions for applicants such as sending the application to the Dean of UG Examinations along with the required documents and payment.

Uploaded by

Kotha Thirupal
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
  • Provisional Certificate Application Form
  • Marks Memo Sheet

Cost of application included in the Fee

SRI KRISHNADEVARAYA UNIVERSITY :: ANANTHAPURAMU


APPLICATION FORM FOR PROVISIONAL CERTIFICATE (ORIGINAL / DUPLICATE)
OR
PROVISIONAL CERTIFICATE CUM CONSOLIDATED MARKS MEMO (ORIGINAL / DUPLICATE)
B.A./[Link]./[Link]./B.B.M./ B.C.A./[Link]./B. Pharm/[Link] & [Link].

1. Name of the candidate


( As registered in this University )
2. Register Number

3. Name of the Degree Course Degree Course Medium Month & Year of Passing
Passed

4. Name of the College &


Period of Study

5. (a) Second Language selected Telugu / Sanskrit / Hindi / Urdu / Persian / Kannada
under Part-I (b) Please ( ü)

(b) Optional subjects chosen 1. 2.


under Part - II
(c) Part - III 3.

6. Address for communication


(Enclose a self addressed envelop with
Rs.40/- worth postal stamp).

MOBILE NO :-
7. Particulars of Fee Payment
By Demand Draft (a) * Challan No:_____________Amount.: _____________
Date _________________
* Challan should be paid at SBI Bank, [Link] Branch only
(Rs. 300/- for Duplicate Provisional Certificate
(Head of Account 34233445841)
With police complaint and affidavit to be enclosed)

(Rs. 300/- for Duplicate P.C cum Consolidated


Marks Memo With police complaint and affidavit to be
(b) D.D. No:_________________Amount.: _____________
enclosed ) Date: ____________ Place ______________________
Name of the Bank: Andhra Bank or State Bank of India

* Please enclose Xerox copies of Marks Lists of three years for Provisional Certificate
* Please enclose Original Marks Lists of three years for P.C cum Consolidated Marks Memo.

Date

Place: Signature of the Candidate

Note:
1. The application should be sent to the Dean of UG Examinations, S.K. University, Anantapuram - 515 003, along
with self addressed cover and D.D/ Challan and a Post Card with Address for sending acknowledgement
towards receipt of the application.
2. The Fee for Original Provisional Certificate is the Fee for Duplicate Provisional Certificate is Rs. 300/- with a
Police Complaint & an Affidavit issued by the Notary.
3. The Demand Drafts should be drawn in favour of The Registrar, S.K. University, Payable at SBI Bank, S.K.
University Branch or Anantapuram.
4. The Provisional Certificate will not be issued in person. The candidates should apply in the prescribed form only.
5. The Provisional Certificate will be sent to the Principals of their respective college and advised to approach the
college for receiving the certificate now applied.
6. U.G. Examination office Telephone Nos. 255830 / 255831.

( P.T.O.)
Month and Year of Marks
Course Subjects [Link].
passing obtained
FIRST YEAR PART I
a. Paper I :(Theory)
b. Paper I :
c. Paper I :
Part II (Specify Subjects)
Paper I :
Paper I :
Paper I :
Practical I :
Practical I :
Practical I :
SECOND YEAR Part I
a. Paper II :
b. Paper II :
c. Paper II :
Part II (Specify Subjects)
Paper II :
Paper II :
Practical II :
Paper II :
Part II (Specify Subjects)
Paper II :
Paper II :
Paper II :
Practical II :
Practical II :
Practical II :
PART - III
Paper II : Environmental Studies
Paper II : Office Automation Tool
THIRD YEAR PART II
(Specify subjects)
Paper III :
Practical III :
Paper IV :
Practical IV :
Paper III :
Practical III :
Paper IV :
Practical IV
Paper III :
Practical III :
Paper IV :
Practical IV
PART-III
Paper III : Citizenship and Education

P.C-cum-Consolidated Marks Memo Total Marks

PART - I
PART - II Optional Subjects (Groups)
PART - III

SRI KRISHNADEVARAYA UNIVERSITY :: ANANTHAPURAMU APPLICATION FORM FOR PROVISIONAL CERTIFICATE (ORIGINAL / DUPLICATE) OR PROVI
P.C-cum-Consolidated Marks Memo Total Marks PART - I PART - II Optional Subjects (Groups) PART - III Course Subject

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