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Handbook and Prospectus - IGNOU

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INDIRAGANDHINATIONALOPENUNIVERSITY<br />

MAIDAN GARHI, NEW DELHI-110068<br />

FORM OF APPLICATION FOR ISSUE OF A DUPLICATE COPY OF<br />

UNIVERSITY DIPLOMA/DEGREE/CERTIFICATE<br />

Note: For Instructions, please see reverse.<br />

To<br />

The Director<br />

StudentEvaluationDivision<br />

Indira G<strong>and</strong>hi National Open University<br />

Maidan Garhi, New Delhi-110068<br />

Sir,<br />

I wish to have a duplicate copy of my Diploma/Degree/Certificate for the Programme<br />

__________________________________ Examination for the following reasons:<br />

The prescribed fee of Rs. 500.00 is submitted herewith.<br />

The required particulars are given below:<br />

Name of C<strong>and</strong>idate (in Block Letters in English): _________________________________<br />

(in Hindi) : _________________________________<br />

Father’s Name (in Block Letters): ____________________________________________<br />

Programme :<br />

EnrolmentNumber:<br />

Examination Passed in Term End Examination - June/December, _______<br />

Result: ______________________<br />

Name of the Study Centre<br />

Name of the Regional Centre<br />

& other particulars<br />

Full PermanentAddress of student<br />

Grade/Division ____________________<br />

: _________________________________________<br />

: _________________________________________<br />

: _________________________________________<br />

: _________________________________________<br />

__________________________________________________________________________________<br />

I solemnly declare that the particulars given above are correct to the best of my knowledge.<br />

Yoursfaithfully.<br />

Signature of the Student<br />

PostalAddress _________________________<br />

____________________________________<br />

Date:<br />

I certify that the above entries made by the applicant are correct.<br />

Signature of Regional Director<br />

With Stamp

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