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Convocation56th Application - Form 21

1) The document is an application form for a degree certificate from Bangalore University's 56th Annual Convocation. 2) It requests information such as the applicant's name, course details, register number, examination details, photos, and payment details. 3) The applicant must promise to uphold the reputation of their profession, support morality and learning, and not use their knowledge for unworthy ends.

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playace007
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133 views1 page

Convocation56th Application - Form 21

1) The document is an application form for a degree certificate from Bangalore University's 56th Annual Convocation. 2) It requests information such as the applicant's name, course details, register number, examination details, photos, and payment details. 3) The applicant must promise to uphold the reputation of their profession, support morality and learning, and not use their knowledge for unworthy ends.

Uploaded by

playace007
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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Bangalore University

Application for Degree Certificate of 56th Annual Convocation – 2021


Name of the Candidate:
(IN BLOCK LETTERS as mentioned in the marks card)
Male/Female/SC/ST/Gen (Pl. tick the box) Male Female SC ST General
Name of the Mother:
Name of the Father:
Course/Degree:
Optional Subjects (B.A, B.Sc, FAD etc)
Title of Thesis (For Ph.D Scholars)
Elective group/paper – B.Com/BBM/ MBA/ M.Com/LLM/
LLB/B.Ed/M.Ed etc
Subject studied – (PG – UG)
Name of the College/Department
Register Number
Details of Examination passed
Semester Month/Year Total Class Semester Month/Year Total Class obtained
Marks obtained Marks
First Sixth

Second Seventh

Third Eighth

Fourth Ninth

Fifth Tenth

Whether passed any previous exam after passing final examination, if yes, please give details:
Semester: Month: Year:

1. I hereby solemnly declare and promise that, if admitted to the degree of _____________ for which I have been
recommended, I shall, in my daily life and Conversation conduct myself as befits as member of this University;
that I shall to the utmost of my capacity and opportunity support the cause of morality and sound learning: and
that as for as in me lies, I shall uphold and advance the social order and the well being of my fellowmen.
2. That I shall faithfully and carefully fulfill the duties of the profession to which I may be admitted by virtue of my
degree; that I shall on all occasions maintain its purity and reputation and that I shall never deviate from the
straight path by making my knowledge subservient to unworthy ends. (In case of non-professional Degrees, the
2nd Paragraph should be scored off)

Place: Date: Signature of the Candidate


Complete postal address
for Communication
Pin:
Mob/Tele: Email ID
Photo Photo Total amount paid:
1. Application Fee:
2. Convocation Fee:
Affix recent Passport size photo in Affix recent Passport size photo in
this box, “with Principal’s seal and this box, “without Principal’s seal 3. Fines:
signature” (FACSIMILE IS NOT and signature” or any mark on the
4. Others:
ACCEPTED) photo.
Total amount:
DD. No. Date:
Bank:
Verified from the office records and found correct and recommended for award of the above degree

Principal’s signature with seal

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