Koneru Lakshmaiah Education Foundation

(Deemed to be University u/s 3 of UGC Act 1956)

K L University
Green fields, Vaddeswaram 522 502, Guntur Dist. A.P. India Website: www.kluniversity.in
Photo

Application for Award of Original Degree

Name of the Candidate (in 1. capital letters as per Provisional Certificate): 2. Parent Name: 3. Date of Birth DD 4. Register No. 5. Programme: B.Tech M.Tech M.B.A. M.Sc M.C.A. Any Other Programme/Branch: MM YYYY Sex Male Female

6. Month & Year Passing Month 7. Address for Communication: Name: Door No.: City/Town/Village: Dist: Phone (LL).: Mail ID.: __________________________________________________________ _________________________ _________________________ _________________________ _________________________ _________________________ Street: _______________________ PIN: _______________________ Year

State: _______________________
Mobile: _______________________

8. Candidates preference for obtaining the Original Degree: At Convocation in Person (Please Tick the appropriate Box 9. Fee Particulars: D.D.No.________________ Date: _______________ Amount Rs._____________________ Bank _________________________________ Branch: ______________________________ (P.T.O) In Absentia ) In Advance

Enclosures to the Application: a. D.D. in favour of the Controller of Examinations, K L University payable at K L University, Vaddeswaram Branch (Name and Register No. may be written on the back side of D.D.). (i) In Advance: Rs.2000/(ii) In Person: Rs.1000/(iii)In Absentia: Rs.1500/(iv) In Post Absentia: Rs.1500/- + yearly late fee Rs.500/b. Photo copy of Provisional Certificate and grade cards for which the degree is sought. c. Original Degree of the previous degree (compulsory) (will be returned after verification). d. Passport size colour photo recently taken. Please Note: The filled in Application form with necessary documents is to be submitted to the Controller of Examinations, K L University, Green fields, Vaddeswaram 522 502, Guntur Dist. A.P. either in person or by Registered Post / Speed Post. For In Absentia & In Advance candidates, the certificate will be sent by Registered Post/ Speed Post, if requested.

Signature of the Applicant

(To be filled in office of the Controller of Examinations)

The candidate has fulfilled all the academic requirements for the award of Degree of: ____________________ The candidate has secured _____________________ Class with CGPA __________________ The Degree Certificate bearing No.__________________________________ is issued Application Processed by: ______________________ Application Checked by: ______________________

Date:

Controller of Examinations

The Certificate is dispatched on ___________________________ by Registered Post.

Office Assistant