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AuthorizationForm 02.5.2023

This document is an authorization form from North South University allowing an alumnus or student to authorize another person to collect documents on their behalf. It requests information about the authorized person such as their name, ID number, address, and relationship to the student. It also requests information about the student, such as their name, ID number, address, and signature. The authorized person's signature is also required. The form notes that original signatures are needed from both the student and authorized person, and those signatures will be verified against university records and photo ID.

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deepkathaa
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109 views1 page

AuthorizationForm 02.5.2023

This document is an authorization form from North South University allowing an alumnus or student to authorize another person to collect documents on their behalf. It requests information about the authorized person such as their name, ID number, address, and relationship to the student. It also requests information about the student, such as their name, ID number, address, and signature. The authorized person's signature is also required. The form notes that original signatures are needed from both the student and authorized person, and those signatures will be verified against university records and photo ID.

Uploaded by

deepkathaa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

COE Form-9

North South University


Application Form of Authorization

To
The Controller of Examinations
North South University
[[[

Bashundhara R/A, Dhaka-1229.

Subject: Authorization for collecting documents on behalf of the NSU alumnus/ student.

Dear Sir,
I, the undersigned, am hereby authorizing the following person to apply for/ collect on my behalf
the document(s) mentioned below (please write down the name(s) of the document(s):

 Main Certificate  Provisional Certificate  Certificate on date of Publication of Result

 Studentship Certificate  Testimonial Certificate  Certificate on Medium of Instruction

 Leave Certificate  Official Transcript  Program duration Certificate

 Character Certificate  Other Documents: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Particulars of the authorized person:


[[

1. Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
2. NID No.: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (Please bring a copy of the NID/ photo ID)
3. Full address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

4. Contact Number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
5. Relation with the student: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

6. Signature of the authorized person with date: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Particulars of the NSU alumnus/ student:


1. Name (in capital letter): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
2. ID#: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ __

3. Full Address (Present): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Remarks


________________________________________________ ______ by
4. Phone/ Cell No: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Controller’s
Office
5. E-mail Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

6. Signature of the NSU alumnus/ student with date: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

N.B: This authorization form must contain the original signatures of the NSU alumnus/ student and
the authorized person. Signature of the alumnus/ student will be compared with
his/ her admission form and the authorized person’s signature will be compared with his/ her
NID/ photo ID.

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