TEZPUR UNIVERSITY
APPLICATION FOR COURSE COMPLETION CERTIFICATE
1. Name in Full (Block letters) :________________________________________________________________
2. Programme completed : ________________________________________________________________
3. Department : ________________________________________________________________
4. Roll No / Enrolment No : ________________________________________________________________
5. Details of the previous Semesters complete:
Sem.
Sem. Type (Autumn/Spring)
Year of Passing
Credits Completed
CGPA
Sem.
Sem. Type (Autumn/Spring)
Year of Passing
Credits Completed
CGPA
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
6. Total credits completed :
7. Whether awarded any E and F Grade(s) in any previous examination : Yes / No
If yes i. In which course(s): Course Code __________ Course Title _________________________________
ii. In which semester these grades are converted to the higher grades: ________________________
iii. Grade awarded after conversion : ___________________________________________________
8. Whether put on academic probation : Yes /No
If yes i. In which course(s): Course Code __________ Course Title _________________________________
ii. When did you clear the academic probation : ____________________________________________
iii. Grade awarded after clearance of academic probation : _______________________________
I, ______________________________________________________________ declare that the above
particulars are true to the best of my knowledge and belief. If found otherwise, I shall be liable to any action.
Full signature of the candidate
ORDER NOTES & ORDERS
RECOMMENDATION OF THE HEAD OF THE DEPARTMENT / CENTRE
Certified that Mr./Ms. ________________________________________ with Roll No./Enrolment No.
____________________________ was a student of the Dept./Centre and passed ___________________
examination with CGPA _____________ and completed the credits requirements (Credit required _______ )
for award of degree / diploma / certificate
Certificate may be issued to Mr./ Ms ___________________________________________________
Head, Dept./ Centre __________________________________
Attach photocopy of the Grade
Cards of the concerned
examinations
Certificate signed
Controller of Examinations
Certificate may be Signed
& issued
Asst. Registrar (Academic)
Checked
certificate may be prepared
Section Officer (Academic)
Examination record Verified
and found correct
Dealing Assistant