UNIVERSITY OF KERALA

www.keralauniversity.edu

APPLICATION FOR PROVISIONAL CERTIFICATE OF DEGREE

Fee Prescribed for Various Examination

Bachelor’s degree Rs 50
Pay-n slip/ D.D.No.-------------------------------
BA, BSc, BCom (Semester),Master's Degree/
Amount Rs. ------Date of payment--------------
PG Diploma,MBBS/BAMS/BHMS/
Name of Bank in the case of D.D.---------------
BTech/LLB,BEd,MPhil, Ph.D Rs 100/
Late fee of Rs 50/ if applied after six months. (D.D. to be drawn in favour of Finance Officer
*
1.Name of the candidate in full as enrolled
in the University records(in block letters)
2.Date of Birth Sex

3.Centre of examination last appeared

4.Address of the applicant to which the
Certificate should be sent (in block letters)
5.Details of Examination passed. (Furnish details for each part of the examination)
Particulars of Examination passed Month Reg.No Centre of Class
(strike off which is not applicable) &yearof Examination
passing
B.A./B.Sc./B.Com. DegreeExamination
Part I – English
Part II – Additional Language(--------)
Part III – Optional Subjects
(a) Main ------------------------
(b) Subsidiaries 1-----------------
2------------------
M.A./M.Sc./M.Com./Degree Examination
Branch & Subject -----------------------
Previous
Final
B.Ed./M.Ed./Degree Examinations
Optional Subjects
Part I - Written B.Ed./M/Ed.
Part II - Practical B.Ed./M.Ed.Thesis
All Other Examinations
Name of the Examination---------------------
Branch and subject ----------------------------

Station:
Date:
Signature of Applicant
*Filled up application should be addressed to the Controller of Examinations.
*Self addressed stamped envelope may be enclosed if the certificate is to be sent by post.
* In addition to this a Search fee of Rs.50/- is to be remitted if the application is not made within
6 months of the publication of the examination.