UNIVERSITY OF AGRICULTURAL SCIENCES, RAICHUR

APPLICATION FOR NINTH CONVOCATION 2017-’18

Convocation Fees:
R 1000/- for Bachelor’s Degree
IN PERSON R 2,500/- for Master’s Degree
R 4,000/- for Ph.D. Degree

Note: While submitting the application, please superscribe “CONVOCATION - IN PERSON”

on the envelope.

The duly filled-in application should be sent to the REGISTRAR, UNIVERSITY OF

AGRICULTURAL SCIENCES, LINGASUGUR ROAD, RAICHUR - 584 104 so as to reach
him on or before 15-04-2019.

1. a. Name of the Candidate in Full

(IN BLOCK LETTERS) as in:

a) II PUC Science Marks Card – for UG Degree SANTOSHKUMAR YADAWAD

b) UG Degree Certificate – for Master’s Degree
c) Master’s Degree Certificate – for Ph.D. Degree

Note 1: If the name has been subsequently changed

and the change has been approved by the
University, both the names should be given along
with copy of the Order of the University.

b. Father’s Name :

Note 2 : As the Degree will be printed, in both PANCHAPPA

Kannada and English, candidate shall provide his
name along with his father’s name in both the
languages clearly.

2. C¨sÀåyðAiÀÄ ¥ÀÆtð ºÉ¸ÀgÀÄ :

(F PɼÀV£ÀAvÉ)-
C) ¸ÁßvÀPÀ ¥ÀzÀ«UÉ - ¦.AiÀÄÄ.¹. ¸Ànð¦üPÉÃl£À°ègÀĪÀAvÉ.
§) ¸ÁßvÀPÉÆÃvÀÛgÀ ¥ÀzÀ«UÉ - ¸ÁßvÀPÀ ¥ÀzÀ« CAPÀ¥ÀnÖ/
¸Ànð¦üPÉÃl£À°ègÀĪÀAvÉ.
PÀ) ¦ºÉZï.r. ¥ÀzÀ«UÉ - ¸ÁßvÀPÉÆÃvÀÛgÀ ¥ÀzÀ« CAPÀ¥ÀnÖ/
¸Ànð¦üPÉÃl£À°ègÀĪÀAvÉ.
¸ÀÆZÀ£É 1 : MAzÀÄ ªÉÃ¼É C¨sÀåyðAiÀÄ ºÉ¸ÀgÄÀ §zÀ¯ÁªÀuÉAiÀiÁVzÀÝ°è,
DvÀ£À ªÉÆzÀ°£À ºÉ¸ÀgÀÄ ªÀÄvÀÄÛ §zÀ¯ÁªÀuÉAiÀiÁzÀ £ÀAvÀgÀzÀ ºÉ¸ÀgÀ£ÀÄß
(§zÀ¯ÁªÀuÉAiÀÄ §UÉÎ «±Àé«zÁå®AiÀÄzÀ DzÉñÀzÀ ¥ÀæwAiÉÆA¢UÉ)
£ÀªÀÄÆ¢¸À
Æ¢¸ÀvÀPÀÌzÀÄÝ.

¸ÀÆZÀ£É 2 : WÀnPÉÆÃvÀìªÀ ¥ÀæªÀiÁt ¥ÀvÀæªÀ£ÀÄß PÀ£ÀßqÀ ªÀÄvÀÄÛ EAVèõÀ£À°è

ªÀÄĢ港ÁUÀ
À¯ÁUÀĪÀÅzÀjAzÀ C¨sÀåyðAiÀÄÄ vÀ£Àß ºÁUÀÆ vÀ£Àß vÀAzÉ zÉAiÀÄ
ºÉ¸ÀgÀÄUÀ¼À£ÀÄß JgÀqÀÆ ¨sÁµÉUÀ¼À°è ¸ÀàµÀÖªÁV £ÀªÀÄÆ¢¸À¨ÉÃPÀÄ.
3. Sex MALE
4. Postal Address for Communication along with Pin code
(IN BLOCK LETTERS)

SANTOSHKUMAR YADAWAD
S/O PANCHAPPA YADAWAD
VIDYA NAGAR, SINDAGI ROAD, INDI 586209 Mobile No: 8123567728
DIST-VIJAYAPUR TQ.INDI Landline No:

5. Details of the completed Degree Programme

Degree Programme Passed (Tick the correct one and Year and ID No. Final
strike off the rest) month OGPA

B. Sc. (Agri.) APRIL-2018 UG14AGR2140 7.92

B. Tech. (Ag. Engg.)

Subject:
M. Sc. (Agri.)
Subject:
M. Tech. (Ag. Engg.)
Subject:
Ph.D.
6. Name of the College from which the above
Degree Programme was completed COLLEGE OF AGRICULTURE,KALABURAGI

1000
Amount Rs.. ––––––––––––––
474406 08/04/2019
DD No. ––––––––––––– Dt: ––––––––
7. Details of Fees Paid STATE BANK OF INDIA ,BRANCH INDI
Bank : –––––––––––––––––––––––––
BSc (Agriculture)
Degree : –––––––––––––––––––––––

Note : Incompletely filled applications and applications without DD shall be rejected.

10/04/2019
Date: –––––––––––––– SIGNATURE OF THE APPLICANT

INSTRUCTIONS:
1. Please fill up all the columns clearly and legibly.

2. Please enclose the attested photo copies of the PUC Marks Card, Provisional
Degree Certificate and OGPA Card of the Degree which you are receiving.

3. Please enclose a self-addressed envelope affixing postage stamp of Rs. 6/- to

facilitate sending Convocation - related information.

4. The DD should be drawn in favour of “The Comptroller, UAS, Raichur” and shall be
enclosed with the application. DDs sent separately shall not be accepted.

5. Please note that the money orders, IPOs and cheques will be not accepted.

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