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Personal Details |
| BITS
Identity Number (IDNO) |
|
Student
Name:
(As it appears in BITS Diploma / Degree certificate) |
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| Diploma /
Degree Name |
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Phone Numbers
(Country Code-Area Code-Number) |
(Office): |
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(Residence): |
| Fax: |
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| Mobile: |
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| E-Mail (Only one valid
E-Mail Id): |
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| |
|
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Complete Postal Address |
| Postal Address |
Line1: |
|
Line2: |
|
Line3: |
| City: |
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| State: |
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| Pin code: |
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| Country |
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| |
|
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Please ticked the required documents: |
| |
Copies |
Charges per copy |
Total Charges |
|
Duplicate
Transcript
|
|
|
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| |
|
Duplicate Provisional Certificate
|
|
|
|
|
(Only issued until the award of final
degree) |
|
Postal Charges (
Registered
Parcel Post RPP / Speed Post
SPP)
|
|
| |
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Total Amount Payable (Duplicate
certificate plus postal charges)
|
| |
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I need duplicate
transcript(s) in sealed envelope(s) and for this I have enclosed
(number) university addresses/addressed envelopes (with ID.NO. in top
left-hand corner).
|
| Note
:
|
Please
ensure that the details provided by you are correct and complete. |
Please
specify only one email id
(Preferably
give your personal Email Id).
|