Please enter the following details for educational verification (For Off-Campus Graduated Students only).

Student's Details
BITS Identity Number (IDNO)  
Student Name:
(As it appears in BITS Diploma / Degree certificate)		  
Sex:
Diploma / Degree Name  
 
Requester Details
Name:  
Designation:  
Postal Address Line1:
Line2:
Line3:
City:  
State:  
Pin code:  
Country  
Phone Number (Country Code-Area Code-Number) (Office):
Fax:  
Mobile:  
E-Mail (Only one valid E-Mail Id):  
Requester Type
client's Details
Name:  
Designation:  
Postal Address Line1:
Line2:
Line3:
City:  
State:  
Pin code:  
Country  
Phone Number (Country Code-Area Code-Number) (Office):
Fax:  
Mobile:  
E-Mail (Only one valid E-Mail Id):  
   
Verification Charges Rs. 2000/- (If by private agencies)
Mode of Post
(If Mode of Post is by hand, mailing charges are not applicable.)		 Charges :
 
Total Amount Payable (Verification plus postal charges)  
 
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).