Transcripts request Form - VIT University

Office of the Controller of ExaminationsApplicationStudent’s DetailsRegister No.:Name:Mobile Number:Email ID:Address for correspondence / Delivery:House/Apt. No:Building/ Street No.:Address line:City: State: Postal code: CountrySl. No. Nature of service required Cost per set/ copy No. of Sets/ Copies Total Amount (Rs.)1. Provisional Grade Sheet (Proof of demand required) Gratis 12. Official Consolidated Grade Sheet (Transcript) Rs.250/ per set3. Official Statement of Grades - Semesterwise (Specify thesemesters+Exam Month)Rs.150//semester4. Provisional Degree Certificate Rs.200/-5. Request for Scanning (Rs.25/ page)Total ChargesPayment mode1VIT Cash Counter Receipt No.: _____________ Dated: _ _ _ / _ _ _ / 201 _ for Rs. ___________1Demand Draft [ should be payable to VIT University at Vellore, India; Cheques / Money Orders/Other form of payments not accepted]Name of the Bank:_________________________________________________________ City:____________________ Country:_______________Demand Draft No.___________ Dated:____________ for Rs.___________Special requests: In sealed cover: Yes/ No Others:___________________________________________________Mode of Delivery (Tick any one; all deliveries require a minimum of 2 working days from the date of confirmation of payment):1Self collection at CoE Office1By post: (Self addressed envelope with necessary postage is required)1Authorized collection ( Any valid Photo ID is required for delivery) : Name of the person:____________________ Relationship:___________Signature of the applicant:_______________________________________ Date:___________________Office Use onlyAppl. No.:______________________ Date of Receipt: _ __ /__ __ /201__Date of Payment Confirmation: _ __ /__ __ /201__Date Centre: Received on : _ __ /__ __ /201__ Processed On: _ __ /__ __ /201__ Delivered on : _ __ /__ __ /201__ Post/ PersonDelivery: Counter Receiver’s Name:_____________________________________________________________________Signature ____________________________________________________ Date: _ __ /__ __ /201__Acknowledgment for Receipt of the ApplicationReg. No.___________ Name:_______________________________Office SealBill No._______ Dt.______ Amt Rs.____________(Please produce this at the time of collection of transcript in person)

Packing Instruction for Sealed CoversPut a tick mark against in the corresponding columns of the documents to be sealed.Pack No. Consolidated Semesterwise Provisional degree Others*123456789101112131415* Other certificates like cover page/ transcript request form from the University to which the student applied