to download Convocation Form. - Tilak Maharashtra Vidyapeeth

To,
The Registrar,
Tilak Maharashtra University,
Gultekdi, Pune 411 037.
Sir,
Tilak Maharashtra Vidyapeeth, Pune – 37.
Application for Degree Certificate
{Énù´ÉÒ |ɨÉÉhÉ{ÉjÉ +VÉÇ
I request to participate in the coming convocation to obtain my Degree / Diploma
certificate. My particulars are as follow-
Seat No.
Fees Rs.
Receipt No.
(Above details will be filled in by the office)
1. Full Name (as per the Mark Sheet) / ºÉÆ{ÉÚhÉÇ xÉÉ´É (MÉÖhÉ{ÉjÉEòÉ´É®ú +ºÉä±É iɺÉä) (all information in Capital Letters) :
Date
Receiver’s Sign.
English
¨É®úÉ`öÒ
(näù´ÉxÉÉMÉ®úÒ)
Surname / +Éb÷xÉÉ´É First Name / º´ÉiÉ:SÉä xÉÉ´É Fathers/Husband’s Name / ´ÉÊb÷±ÉÉÆSÉä/{ÉiÉÒSÉä xÉÉ´É
2.Address for correspondence /{ÉjÉ´ªÉ´É½þÉ®úÉSÉÉ {ÉkÉÉ : _________________________________________________
City : _______________, Taluka : _______________, District : ______________, PIN Code :___________.
Phone No:___________________.
3.
Name of the Exam. Passed /
=kÉÒhÉÇ {É®úÒIÉäSÉä xÉÉ´É
Month & Year of Passing /
=kÉÒhÉÇ ¨É½þÒxÉÉ ´É ´É¹ÉÇ
Subject / ʴɹɪÉ
Examination Seat Number /
{É®úÒIÉÉ +ɺÉxÉ Gò¨ÉÉÆEò
Center of the Examination /
{É®úÒIÉÉ Eåòpù
Class / ¸ÉähÉÒ
4. I will accept the certificate IN PERSON / BY POST (Make a tick in right block) ¨ÉÒ
º´ÉiÉ: {Énù´ÉÒ|ÉnùÉxÉ ºÉ¨ÉÉ®Æú¦ÉÉºÉ ={ÉκlÉiÉ ®úɽþÒxÉ. |ɨÉÉhÉ{ÉjÉ {ÉÉäº]õÉxÉä {ÉÉ`ö´ÉÉ´Éä (ªÉÉäMªÉ SÉÉèEò]õÒiÉ JÉÚhÉ Eò®úÉ´ÉÒ)
5. D. D. Number / Bank challan no. Date of deposit b÷Ò.
b÷Ò. Gò¨ÉÉÆEò / ¤ÉÄEò SɱÉxÉ Gò¨ÉÉÆEò
VɨÉÉ Eäò±ªÉÉSÉÒ iÉÉ®úÒJÉ
6. I have read the Instructions carefully & abide of the same. I have attached a xerox copy of Mark sheet./
¨ÉÒ ºÉnù®ú ÊxÉªÉ¨É ´ÉÉSɱÉä +ºÉÚxÉ iÉä ºÉ´ÉÇ ¨É±ÉÉ ¨ÉÉxªÉ +ɽäþiÉ. iɺÉäSÉ ªÉÉ +VÉÉǺÉÉä¤ÉiÉ ¨ÉÒ MÉÖhÉ{ÉjÉÒEäòSÉÒ ZÉä®úÉìCºÉ |ÉiÉ VÉÉäb÷iÉ +ɽäþ.
Date / iÉÉ®úÒJÉ : Signature / º´ÉÉIÉ®úÒ
(Write both the copies for correspondence regarding convocation / {Énù´ÉÒ|ÉnùÉxÉ |ɨÉÉhÉ{ÉjÉɺÉƤÉÆvÉÒ {ÉjÉ´ªÉ´É½þÉ®úɺÉÉ`öÒ nùÉäx½þÒ Ê`öEòÉhÉÒ {ÉkÉÉ Ê±É½þÉ´ÉÉ)
Name / xÉÉ´É : Name / xÉÉ´É :
Address / {ÉkÉÉ : Address / {ÉkÉÉ :
District / ÊVɱ½þÉ : PIN / Ê{ÉxÉ : District / ÊVɱ½þÉ : PIN / Ê{ÉxÉ :

Instructions
1. The Exact date & time of Ceremony of the Convocation will be conveyed by a letter to
those students participate in the convocation in person. / {Énù´ÉÒ|ÉnùÉxÉ ºÉ¨ÉÉ®Æú¦ÉɺɨɪÉÒ VÉä Ê´ÉtÉlÉÔ ºÉ¨ÉIÉ
ªÉä>ðxÉ |ɨÉÉhÉ{ÉjÉ PÉähÉÉ®ú +ɽäþiÉ, +ÉÉ Ê´ÉtÉlªÉÉÈxÉÉ {ÉjÉÉuùÉ®äú {Énù´ÉÒ|ÉnùÉxÉÉSÉÒ ÊxÉÎSÉiÉ iÉÉ®úÒJÉ ´É ´Éä³ý Eò³ýÊ´ÉhªÉÉiÉ ªÉä