North-Eastern Hill University

North-Eastern Hill University NEHU Campus, Shillong – 793022 (Meghalaya)

HEAD QUARTERS: SHILLONG – 793022 APPLICATION FOR DEGREE CERTIFICATE

1. Name of the Degree Applied for: …………………………………………………………………….. 2. Mention Pass or Honours, with Class, Division and Subjects etc: …………………………………………………………………….. 3. Name of the Candidate (in block letters): ……………………………………………………………. 4. Registration No ………………………………………………………………………………………. 5. Father’s Name: ……………………………………………………………………………………….. 6. Roll No: ……………………………... year of Passing: ……………………………………………... 7. Name of the College/ Department …………………………………………………………………… Complete: 8. Address for Correspondence ………………………………………………………………………….. With contact Number if any: ………………………………………………………………………….. ……………………………………………………………………………………...... ……………………………………………………………………………………...... 9. Number & Date of the instrument Of payment of prescribed fee …………………………………………………………………………..

Countersigned by: Full Name & Signature of the Principal or Head of the Department Candidate (With Office Seal)

Station: ……………………………… Date: …………………………………

Note: The prescribed fee for the Certificate is Rs.300/- (Rupees Three Hundred) only, Payment be made by going to this website https://www.onlinesbi.com/ and then click on State Bank Collect. e. N.B.: The Candidate should submit an attested Mark Sheet and Xerox copy of Registration Card along with the Application Form.