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Dr B R AMBEDKAR NATIONAL INSTITUTE OF TECHNOLOGY JALANDHAR Application form Nature of document required (Please √ whichever is applicable) Fee paid Rs._______________ 1. Transcripts (No. of copies- ) NIT Receipt No.______________ Dt.______________ 2. Verification of degree Bank Draft No._______________ Dt.______________ 3. Issue of duplicate degree Name of the Bank______________________________ 4. Issue of original degree 5. Issue of duplicate grade sheet 6. Issue of migration certificate 7. Issue of medium of instruction certificate For Office Use 8. Issue of bonafide certificate 9. Issue of fee structure Diary No………………….. 10. Issue of provisional degree certificate(pass out students) Received on ……………… 11. Issue of provisional certificate(existing students) Concerned person/Section 12. Issue of railway concession form ……………………………. 13. Tuition fee certificate for claiming income tax deduction 14. Other document, if any………………………………….. 1. Name of the applicant : _______________________________ 2. Male or Female : _______________________________ 3. Father’s Name : _______________________________ 4. Mother’s Name : _______________________________ 5. Course(whether B.Tech/M.Tech/M.Sc./Ph.D) : _______________________________ 6. Branch//Discipline : _______________________________ 7. Roll No./Batch/semester : _______________________________ 8. Year of admission : _______________________________ 9. Marks/SGPA/CGPA obtained : Semester 1st 2nd 3rd 4th 5th 6th 7th 8th SGPA CGPA 10. Year of passing : _______________________________ 11. Institution where studying presently : _______________________________ 12. University to which migration is sought : _______________________________ 13. Reason for migration : _______________________________ 14. Name and Address for correspondence : _______________________________ _______________________________ _______________________________ 15. Name and Address for dispatch of degree/ : _______________________________ Document _______________________________ _______________________________ Note: Please ignore which is not applicable Signature of applicant Date Mobile No. Email INSTRUCTIONS FOR THE STUDENTS Student’s dealing timings in Academic Branch are 11.00 a.m. to 1.00 p.m. and 3.00 p.m. to 5.00 p.m. No student can directly enter academic section. Every student has to report on reception only If any student /guardian/parents wants to contact any official of the academic branch, they have to report on reception for permission. All the students must adhere to the notices issued for them from time to time. Students/parents/guardian will have to deliver and receive the documents from reception only. For issuance of any of the document/certificate as mentioned in the application form, students are advised to go through the website (www.nitj.ac.in) for detailed instructions Identity Card and Character certificate will be issued by the Proctor (Prof S K Sinha, Textile Technology Department)with effect from 28-9-2011 as per order no.PA/NITJ/8213-15. For these document, the students are advised to contact Proctor’s office directly. For any problem, contact/email to the following contact persons alongwith copy of email to email@example.com CONTACT PERSONS Name Prathiba/ Raminder Kaur Bhupinder Singh Sunil Kumar Madan Lal Harsh Malhotra Email firstname.lastname@example.org email@example.com firstname.lastname@example.org email@example.com firstname.lastname@example.org Phone No. 0181-2690302 0181-2690302 0181-2690302 0181-2690302 0181-2690302 Academic Year of admission Year of Year of Year of Year of Programme admission admission admission admission B.Tech. 1989 1991 1992 1994 1995 1990 2000 1993 1996 1998 2003 2002 1997 1999 2001 2007 2005 2006 2004 2011 2009 2010 2008 M.Tech./ 2007 2010 2008 2009 2006 M.Sc./ 2011 Ph.D.
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