COLLEGE OF APPLIED SCIENCE,VATTAMKULAM
(Managed by IHRD, a Govt of Kerala Under taking)
Naduvatam, P.O. Sukapuram, Edappal,Malappuram D.T, Tel: 0494 2689655
e-mail [email protected], [email protected]
Application for Student Verification
- Sl. Particulars
- Details claimed by the Applicant
1234567
Name of Candidate Date of Birth a) Course attended a) Duration of Course a) Admission No. b) Branch : b) Scheme : b) Year of study:
Month& Year of Final Semester Exam.
Register No. of University Exam.
Final year marks/: Grade(CGPA)
Result of Exam. as per college records
89
Additional information required, if any Details of Documents attached for
Verification.(attach photocopy/
10
scanned image with email)
Details of Institution/Agency requesting verification 1. Name of Company/Agency/Institution
2. Adderss 3. Phone No. 4. Email ID
Name & Designation of person requesting information
5.
Emai-ID to which verification report to be send
6.
Address to which verification report to be send by registered post
7. ( please add Rs.50/- towards postage along with the fee paid)
- DD. No. ……………………………. For Rs.
- /-
- 8. Details of Verification fee enclosed
- dated …………………………
- Bank remittance on
- at branch
Note : 1. For each candidate use separate form. But Fee for multiple candidates can be paid by a single DD drawn in favor of Principal/bank remittance. Fee once paid is non- refundable under any circumstance.
2. Processing Fee of Rs. 500/- per candidate (add Rs. 50/- for postage, if necessary) should be paid in the form of DD drawn in favor of “The Principal, College of Applied Science, Vattamkulam” payable at “ SBT, Edapal” or bank transfer to the SB Account no.
67000647960 (IFSC code: SBTR 0000687 )
3. Verification report will be forwarded within 4 working days from the date of receipt of application along with fee.
Date
Signature
STUDENTS VERIFICATION CERTIFICATE