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Karnataka State Law University
Photography
, Navanagar, Hubli
Application Form for Degree Certificate
2022-23

Annual 1.Name
/Special Convocation for Conferring Degree of the Degree--------------------------------------------
The Registrar (Evaluation), Karnataka State Law 2.Class
University, obtained------------------------------------------------
Hubli 3.Year
of passing---------------------------------------------
Respected
Sir, 4.Date
of declaration of result---------------------------------

I am applying for the Degree at the University Convocation to be held in

………………………………………………………………………………………………………….
I have not applied for conferring the Degree mentioned below prior to this application
.
I have listed below all the details required for conferring the degree.
All the particulars required for conferring the degree are prescribed below:

A.No. Details
Sl.No. Particulars To be filled by the
candidate

1 Full name
of the candidate(as per Degree Marks Card)

2
Male /Female

3 Name of the College with code No./PGDept

.

4
Name of the degree/diploma for which the candidate is applying

5 Class
obtained

6 Examination Registration
No.

7 Month & Year

of passing the examination

8
Whether applicant is eligible to take the Degree in Person or in
Absentia

9 Nationality
​

10 Attested Marks Cards copy of all the semester

should be enclosed with the Convocation Application .

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11 Fees paid Amount

12 Fees paid bank Reference No

ACKNOWLEDGMENT
Sl.No. of Application:...................
Received the Convocation application form from Shri/Smt. ………………………………………………………………………… for the
Degree of …………………………………………………………………………………… today the ………………………………

1.Degree : ..........................
2.Class : .......................... Examination Section
3.Year of Passing : .......................... Karnataka State Law University, Hubli

Note : BRING THE ATTESTED COPIES OF THE FINAL YEAR MARKS CARD AND CONVOCATION FEES
PAID RECEIPTS FOR INQUIRY.

Full Name(as per Final Year Marks Card)(Write in Kannada and English version)

Candidate's name :
Name of the Candidate :

Father's name :
Father's Name :

Mother's name :
Mother's Name :

Nickname :
Surname :

V.S.: 1. The degree certificate will be issued in Kannada and English. The candidate, while submitting the
application for the convocation, should clearly write his/her full name in both Kannada and English as
mentioned in the mark sheet.
Special Instructions :
1. While filling application for convocation the candidate should write his/her name both in Kannada and
English version, so as to enable us to write his/her name in the Degree Certificate.
The prescribed fees of Rs…………………………………………is paid through SBI Collect Reference No
DU…….………………. dated ……………………
I hereby declare that the above statement is correct.
I declare that the statements made above are correct.

Postal address: Address for Yours

correspondence(in capital) faithfully

Contact No: _______________________

Signature
of the Candidate

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