AMITY UNIVERSITY

————— U T T A R P R A D E S H —————

Application Form for Issue of Official Transcript

Note: Please read instructions given overleaf carefully before applying through Head of the Institution.

1. Name of the Candidate ___________________________________________________________

(in block letters)
2. Father’s/Mother’s Name __________________________________________________________

3. Date of Birth ________________ 4. Programme Title _________________________________

5. Year of passing ______________ Roll No. _______________ Enrolment No. _______________

6. Details of fee paid for transcription:

DD No. ____________________ Date ____________________ Amount ____________________

7. Details of courses offered and qualified semester wise:

Sl. Course Max. Marks Grade
Semester Course Title SGPA
No. Code Marks Obtained Obtained

(Please enclose certified photocopies of Statement of Grade issued by the University.)

CGPA __________________ P.T.O
_____________________________________
Signature of Head Examination Services
8. Local Residential address with Telephone No. _________________________________________

_______________________________________________________________________________

9. Permanent Residential address with Telephone No. _____________________________________

_______________________________________________________________________________

10. Have you applied for transcript earlier? If so, please mention: (a) Date ______________________
(b) University/Institution______________________

11. Name of University/Institution for which official transcript/s are now required with complete address(s).
1. __________________________ 2. __________________________
__________________________ __________________________
__________________________ __________________________
__________________________ __________________________
3. __________________________ 4. __________________________
__________________________ __________________________
__________________________ __________________________
__________________________ __________________________

_______________________
Date _______________________ Signature of Student

12. Above details given by the candidate are verified from record of the Institute. He/She bears a good moral character. It is
recommended that the Official Transcript may be issued to the candidate.

_____________________________________
Signature of Head Examination Services

________________________________________
Date: Signature of Director Academics

FOR OFFICE USE ONLY

An amount of Rs. _____________ received in cash/vide DD No. _______________ Dated _____________

Accounts Officer Finance Officer

Transcript issued on _________________

Controller of Examinations

INSTRUCTIONS FOR FILLING UP THE FORM

1. No transcript will be issued to any applicant until and unless the student encloses a copy of the letter of the foreign University/Institution for which transcript
is sought. The candidate is also requested to mention the name of foreign University/Institution with full address/es, where he/she wants to apply. No
transcript will be issued without any address of foreign University/Institution.
2. The candidate should write his/her name, roll no., name of the examination, year in which passed, subject, course wise details of score etc. correctly and
legibly.
3. The required transcript will be issued after a period of fifteen working days (two weeks or so) excluding Saturday/Sunday and other Gazetted holidays from
the date of submission of application with prescribed fee of Rs. 1000/- per copy of transcript
4. Photocopies of the Statement of Grades of the Examinations passed in this University for which transcript is required should be enclosed with the application
form.
5. The candidate is also requested to enclose a photocopy of the receipt/DD in token of having deposited the fee with Finance Officer.
6. The result of the student i.e name, examination, year Grades Obtained, and division will be verified by the Head of the Institution. Thereafter, the official
transcript will be delivered to the student in a sealed envelop for dispatch. By the student after affixing the required postal stamps on the sealed envelops and
weighing the same from the Post Office/Courier Department.