Registrar’s Office

RO.1044/04C

COLLECTION OF DEGREE /DIPLOMA SCROLL AND COMPLIMENTARY TRANSCRIPT

Please select, by ticking [], and complete either Option A or B below and return the completed form
to Registrar’s Office, National University of Singapore, University Hall, Lee Kong Chian Wing, #UHL-
04-01, 21 Lower Kent Ridge Road, Singapore 119077 (Fax No. : 65-67786371) with a photocopy of
the graduate’s identity card/passport.

Graduate’s Name in full: (Please use BLOCK LETTERS) Identity Card / Passport No.:

Degree: Year of Graduation:

Graduate’s Signature Date (DD/MM/YYYY)

 OPTION A: COLLECTION BY PROXY

I authorize the following person to collect my degree/diploma scroll and a complimentary
transcript on my behalf.
*Authorized Person’s Name in full: Identity Card / Passport No.:
(Please use BLOCK LETTERS)

* This person must produce his/her identity card or passport, for identification purposes, when collecting the scroll
and complimentary transcript.

 OPTION B: SEND BY MAIL / COURIER SERVICE

I request that the University send my degree/diploma scroll and complimentary transcript to
me with the understanding that the University would not be able to replace the scroll should it
be lost or irreversibly damaged in the mail.
Please complete the following mailing and payment details:
Name of Graduate: (Please use BLOCK LETTERS)

#
Email address: Contact No.:

(# required by courier service)

Address:

Attached is a bank draft/money order for S$ **, made payable to

“National University of Singapore”.
** Administrative Charges: S$ For Office Use Only:
- for Singapore address 10.00
- for Overseas address 60.00
The degree scroll will be sent by
 SingPost LUM Service (for Singapore address)
 Federal Express (for Overseas address)

(Amount to be credited into A/c C-003-000-003-001/732101 Tax Code : IZ)

Updated 01 Sep 09

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