Arunachal University of Studies,

Knowledge City, NH-52, Namsai,

Arunachal Pradesh - 792103

Course Completion Certificate Application

The Certificate will be dispatched within 8 Weeks from the receipt of complete Application.
FILL THE DETAILS IN BLOCK LETTERS

Enrollment Number :- __________________________________________________________

Recent Passport
Size Photograph.
The Photo may
Applicant Name :- __________________________________________________________
appear on Final
Document.
Father’s Name :- __________________________________________________________

Mother’s Name :- __________________________________________________________

Programme Title :- ___________________________________________________________________________________

Address :- ___________________________________________________________________________________

_________________________________________________________________________________________________PIN_____________

EMAIL : - ________________________________________________________ MOBILE : - ________________________

Caution : Pl mention address correctly. The university shall not be held responsible for adverse consequences arises due to wrong address.
MODE of PAYMENT
• Enclosed Demand Draft of ₹ 1,500/- in Favor of Arunachal University of Studies Payable at Namsai, Arunachal
Pradesh.
OR
• Enclose Transaction Slip of ₹ 1,500/- of Online Transfer in the Account of Arunachal University of Studies,
Account No. 33162597948, IFSC Code : SBIN0013311, State Bank of India, Namsai, Arunachal Pradesh
DECLARATION
I hereby declare that all the information provided by me is true to best of my knowledge & belief, also all the documents
submitted are true copies of the original. I further declare that I am abided by the regulations and eligibility conditions of
the University. I understand that I may be required to furnish additional information/ document incase pf requirement
from the University. I also understand that my candidature or award from the University can be withdrawn at any given
point of time even after issuance, if, the information submitted by me is found to be incorrect or counterfeited.

Signature of Applicant Date : _______________________________

MANDATORY ENCLOSURES
• Demand Draft or Online Transaction Slip.
• Self-Attested 10th and Onwards Educational Proof.
• Self-Attested Experience Certificate if, any.