North East Christian University
(Established under the North East Christian University Act 2012 and U/S 2 (f) of UGC Act 1956.)
Burma Camp East Block, Dimapur- 797112 : Nagaland
Bu
Application for the award of final DEGREE / DIPLOMA
The form should be complete in all respects and to be filled in by student in English (CAPITAL LETTERS) with blue ink pen.
Name of Course D I P L O M A I N C O M P . A P P
Year of Completion
DOB 2D D8 / 0M M
9 / Y2 Y0 Y
0 5Y
Paste recent
Enrollment no. A 2 0 2 3 G 0 0 0 0 0 4 3 3 Passport Size
Photograph. It will
be printed on
M A N A S S A X E N A Degree/ Diploma.
Student’s Name
Father’s Name S H I V E N D R A S A X E N A
Mother’s Name M A N I S H A S A X E N A
Address 2 4 6 / 3 S H A N T I V I H A R
G O V I N D H G A R H
City D E H R A D U N Pin 2
2 4 8 0 0 11
Contact No 7 0 1 7 3 1 7 5 8 2
Details of Examinations passed:
Year Roll.no Maximum Marks Marks Obtained
I Year 23008401001 700 469
II Year 23008402991 700 420
III Year
IV Year
Original Migration / TC submitted Yes TICK No
Attach the following Documents herewith:
Photocopy of Aadhar Card (Both Side) Self Attested
Photocopy of High School Marks Sheet and Certificate Self Attested
Photocopy of Intermediate Mark Sheet & Certificate Self Attested
Photocopy of Graduation Marksheets of All Semester/ Year Self Attested
Photocopy of Marksheets of P.G. Course Self Attested
Read the form carefully and all columns to be filled in by the applicant himself/ herself.
DECLARATION
I hereby declare that the information/ document/s submitted by me, is/are true copies of the original and are true to the best of
my knowledge & belief. I further declare that I am abided by the regulations and eligibility conditions of the University. I
understand that I may be required to furnish additional information/ document/documents incase the University so demands. I
also understand that my candidature or Degree/Diploma/Certificate from the University can be withdrawn at any given point of
time even after issuance of the same, if the said information/document/s submitted by me is/are found to be incorrect or
counterfeited.
Signature of Applicant Date
