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Price : Rs. 200/-

Price : Rs. 200/- PÀ£ÁðlPÀ gÁdå PÁ£ÀÆ£ÀÄ «±Àé«zÁå®AiÀÄ Karnataka State Law University, Navanagar,

PÀ£ÁðlPÀ gÁdå PÁ£ÀÆ£ÀÄ «±Àé«zÁå®AiÀÄ

Karnataka State Law University, Navanagar, Hubli

¥ÀzÀ« ¥ÀæªÀiÁt ¥ÀvÀæ ¥ÀqÉAiÀÄ®Ä ¸À°è¸ÀĪÀ Cfð

Application Form for Degree Certificate

Passport Size

Photography

ªÁ¶ðPÀ / «±ÉõÀ WÀnPÉÆÃvÀìªÀzÀ ¥ÀzÀ« ¥ÀæzÁ£À

Annual /Special Convocation for Conferring Degree

PÀÄ®¸ÀaªÀgÀÄ (ªÀiË®åªÀiÁ¥À£À), PÀ£ÁðlPÀ PÁ£ÀÆ£ÀÄ «±Àé«zÁå®AiÀÄ, ºÀħâ½î

The Registrar (Evaluation), Karnataka State Law University, Hubli

ªÀiÁ£ÀågÉ,

Sir,

1. ¥ÀzÀ«AiÀÄ ºÉ¸ÀgÀÄ

Name of the Degree……………………………….

2. ¥Á¸ÁzÀ ±ÉæÃtÂ

Class obtained …………………………………….

3. ¥Á¸ÁzÀ ªÀµÀð

Year of passing…………………………………….

4. ¥sÀ°vÁA±À ¥ÀæPÀn¹zÀ ¢£ÁAPÀ

Date of declaration of result

…………………….

£Á£ÀÄ

wAUÀ½£À°è £ÀqÉAiÀÄ°gÀĪÀ «±Àé«zÁå®AiÀÄzÀ WÀnPÉÆÃvÀìªÀzÀ°è ¥ÀzÀ« ¥ÀqÉAiÀÄ®Ä Cfð ¸À°è¸ÀÄwÛzÉÝãÉ.

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

F PɼÀUÉ £ÀªÀÄÆ¢¹zÀ ¥ÀzÀ«AiÀÄ ¥ÀæªÀiÁt ¥ÀvÀæ PÉÆÃj £Á£ÀÄ EzÀPÀÆÌ ªÉÆzÀ®Ä Cfð ¸À°è¹gÀĪÀÅ¢®è.

I have not applied for conferring the Degree mentioned below prior to this application.

£Á£ÀÄ ¥ÀzÀ« ¥ÀæªÀiÁt ¥ÀvÀæPÉÌ CUÀvÀå«gÀĪÀ J®è ªÀiÁ»wUÀ¼À£ÀÄß F PɼÀUÉ PÁt¹zÉÝãÉ.

All the particulars required for conferring the degree are prescribed below :

C.£ÀA.

«ªÀgÀUÀ¼ÀÄ

C¨sÀåyðAiÀÄÄ ¨sÀwð ªÀiÁqÀ¨ÉÃPÀÄ

Sl. No.

Particulars

To be filled by the candidate

1

C¨sÀåyðAiÀÄ ¥ÀÆtð ºÉ¸ÀgÀÄ (CAPÀ¥ÀnÖAiÀÄ°èzÀÝAvÉ)

 

Name of the candidate (as per Marks Card)

2

¥ÀÄgÀĵ/¹ÛçÃÀ

 

Male/Female

3

ªÀĺÁ«zÁå®AiÀÄzÀ ºÉ¸ÀgÀÄ, PÉÆÃqÀ £ÀA./¸ÁßvÀPÉÆÃvÀÛgÀ «¨sÁUÀzÀ ºÉ¸ÀgÀÄ

 

Name of the College with code No./P.G. Dept.

4

C¨sÀåyðAiÀÄÄ ¥ÀqÉAiÀÄ°gÀĪÀ ¥ÀzÀ«/r¥ÉÆèêÀiÁzÀ ºÉ¸ÀgÀÄ

 

Name of the Degree/Diploma for which applied

5

¥Á¸ÁzÀ ªÀUÀð

 

Class obtained

6

¥ÀjÃPÉëUÉ PÀĽvÀ ¸ÀܼÁAPÀ

 

Examination Registration No.

7

¥ÀjÃPÉë ¥Á¸ÁzÀ wAUÀ¼ÀÄ ªÀÄvÀÄÛ ªÀµÀð

 

Month & Year of passing the examination

8

¤AiÀÄ«ÄvÀ «zÁåyðAiÀiÁV ¥ÀjÃPÉëAiÀÄ£ÀÄß ¥Á¸ÁVgÀĪÀzÀÄ.

 

As a Regular candidate.

9

G¥À¹ÜvÀjzÀÄÝ/C£ÀÄ¥À¹ÜvÀjzÀÄÝ ¥ÀzÀ« ¥ÀqÉAiÀÄ®Ä CºÀðjgÀĪÀgÀÄ.

 

Whether applicant is eligible to take the Degree in “Person” or in “Absentia”.

10

gÁ¶ÖçÃAiÀÄvÉ

 

Nationality

11

¥Á¸ÁzÀ J®è ¸É«Ä¸ÀÖgï£À zÀÈrüÃPÀÈvÀ CAPÀ¥ÀnÖUÀ¼À£ÀÄß WÀnPÉÆÃvÀìªÀzÀ CfðAiÀÄ eÉÆvÉUÉ ®UÀwÛ¸À¨ÉÃPÀÄ.

 

Attested Marks Cards copy of all the semester should be enclosed with the Convocation Application.

ACKNOWLEDGMENT

Sl. No. of Application :………………………

Received the Convocation application form from Shri/Smt.

for the Degree of

today the

1. Degree

2. Class : ………………………

………………………

:

3. Year of Passing

:

………………………

4. Date of declaration :

………………………

Note

:

BRING

CHALLAN/D.D. FOR ENQUIRY IN.

COPIES

THE

ATTESTED

OF

THE

FINAL

YEAR

Examination Section Karnataka State Law University, Hubli

MARKS

CARD

AND

CONVOCATION

FEES

PAID

¥ÀÆtð ºÉ¸ÀgÀÄ (PÉÆ£ÉAiÀÄ ªÀµÀðzÀ CAPÀ ¥ÀnÖAiÀÄ°è EzÀÝAvÉ) (PÀ£ÀßqÀ ªÀÄvÀÄÛ EAVèµï ¨sÁµÉAiÀÄ°è §gɬÄj)

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

1. C¨sÀåyðAiÀÄ ºÉ¸ÀgÀÄ

:

Name of the candidate

2. vÀAzÉAiÀÄ ºÉ¸ÀgÀÄ

:

Father’s Name

3. vÁ¬ÄAiÀÄ ºÉ¸ÀgÀÄ

:

Mother’s Name

4. CqÀØ ºÉ¸ÀgÀÄ

:

Surname

«.¸ÀÆ. : 1. ¥ÀzÀ« ¥ÀæªÀiÁt ¥ÀvÀæªÀ£ÀÄß PÀ£ÀßqÀ ºÁUÀÆ DAUÀè ¨sÁµÉAiÀÄ°è ¤ÃqÀ°zÀÄÝ, C¨sÀåyðAiÀÄÄ WÀnPÉÆÃvÀìªÀPÉÌ CfðAiÀÄ£ÀÄß ¸À°è¸ÀĪÁUÀ CAPÀ¥ÀnÖAiÀÄ°è £ÀªÀÄÆ¢¹zÀAvÉ vÀªÀÄä ¥ÀÆtð ºÉ¸ÀgÀ£ÀÄß PÀ£ÀßqÀ ºÁUÀÆ EAVèµï JgÀqÀÆ ¨sÁµÉAiÀÄ°è ¸ÀàµÀÖªÁV §gÉAiÀÄĪÀÅzÀÄ.

2. C¨sÀåyðAiÀÄÄ ºÀÄAr (rªÀiÁAqÀ qÁæ¥sïÖ)AiÀÄ »A§¢AiÀÄ°è vÀ£Àß ºÉ¸ÀgÀ£ÀÄß ¸ÀàµÀÖªÁV £ÀªÀÄÆ¢¸ÀĪÀÅzÀÄ. ºÀÄArAiÀÄÄ ºÀħâ½îAiÀÄ°è ¥ÁªÀwAiÀiÁUÀĪÀAwgÀ¨ÉÃPÀÄ.

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.

2. The candidate must write his/her name on the back side of the Demand Draft. The Demand Draft must be payable at Hubli and be drawn in favour of Finance Officer, Karnataka State Law University, Navanagar, Hubli.

UÉÆvÀÄÛ¥Àr¹zÀ ±ÀÄ®Ì gÀÆ

UÀ¼À£ÀÄß

«±Àé«zÁå®AiÀÄz “«vÁÛ¢üPÁjUÀ¼ÀÄ, PÀ£ÁðlPÀ gÁdå PÁ£ÀÆ£ÀÄ

¢£ÁAPÀ

«±Àé«zÁå®AiÀÄ, ºÀħâ½î” EªÀgÀ ºÉ¸ÀjUÉ ºÀÄAr (rªÀiÁAqÀ qÁæ¥sïÖ) £ÀA

ªÀÄÆ®PÀ vÀÄA§¯ÁVzÉ.

The prescribed fees of Rs………………………………………is paid in the form of Demand Draft bearing

No …………………. dated ………………………drawn in favour of the “Finance Officer, Karnataka State Law University, Hubli,

payable at Hubli.

ªÉÄð£À ºÉýPÉAiÀÄÄ ¸ÀªÀÄ¥ÀðPÀªÁVzÉAiÉÄAzÀÄ £Á£ÀÄ F ªÀÄÆ®PÀ WÉÆö¸ÀÄvÉÛãÉ.

I declare that the statements made above are correct.

CAZÉ «¼Á¸À : Address for correspondence (in capital)

vÀªÀÄä «±Áé¹

Yours faithfully

C¨sÀåyðAiÀÄ ¸À»

Signature of the Candidate

1.

ªÀÄzÀĪÉAiÀiÁzÀ ºÉtÄÚ ªÀÄPÀ̼ÀÄ UÀAqÀ£À ºÉ¸ÀgÀ£ÀÄß ¥ÀqÉzÀÄPÉÆAqÀ CxÀªÁ AiÀiÁªÀÅzÉà ªÀåQÛ ¨ÉÃgÉAiÀĪÀjUÉ zÀvÀÄÛ ºÉÆÃzÀ ¥Àæ¸ÀAUÀªÀ£ÀÄß ºÉÆgÀvÀÄ¥Àr¹ ºÉ¸Àj£À°è §zÀ¯ÁªÀuÉ ªÀiÁqÀĪÀÅzÀPÉÌ C£ÀĪÀÄw¬Ä®èzÉ «zÁåyðUÀ¼ÀÄ F ªÉÆzÀ®Ä «±Àé«zÁå®AiÀÄzÀ°è zÁR¯ÁzÀ ºÉ¸Àj£ÉÆA¢UÉ ¥ÀvÀæ ªÀåªÀºÁgÀ ªÀiÁqÀ¨ÉÃPÀÄ.

Change in name is not permitted as in the case of women adopting the name of her husband or in the case of person changing the name after he goes in adoption to some other person. The candidate should however correspond with the name that is already recorded in the University.

2. C¨sÀåyðUÀ¼ÀÄ vÀªÀÄä ºÉ¸ÀgÀ£ÀÄß ¸ÀàµÀÖªÁV §gÉAiÀĨÉÃPÀÄ. CfðAiÀÄ°è §gÉzÀ ºÉ¸ÀgÀÄ «±Àé«zÁå®AiÀÄzÀ zÁR¯ÉAiÀÄ°è £ÀªÀÄÆ¢¸À¯ÁzÀ ºÉ¸ÀjUÉ ¸Àj ºÉÆAzÀ¢zÀÝ°è ¸ÀzÀj Cfð gÀzÁÝUÀĪÀzÀÄ. MAzÀÄ ªÉÃ¼É C¨sÀåyðAiÀÄ ºÉ¸Àj£À §zÀ¯ÁªÀuÉUÉ «±Àé«zÁå®AiÀÄzÀ PÀÄ®¸ÀaªÀgÀÄ C£ÀĪÀÄw PÉÆnÖzÀÝ°è D ¥ÀvÀæzÀ ¥ÀæwAiÀÄ£ÀÄß CªÀ£ÀÄ/CªÀ¼ÀÄ CfðAiÀÄ eÉÆvÉUÉ ºÁdgÀ ¥Àr¸À¨ÉÃPÀÄ.

Candidates shall write their names legibly. If the name written in the application does not tally exactly with that of the University records, the application will be rejected unless the candidate submits with the application the original letter from the Registrar, Karnatak State Law University permitting him/her for the change in name.

3. C¨sÀåyðAiÀÄÄ vÀ£Àß «¼Á¸ÀªÀ£ÀÄß ¥ÀÄl¸ÀASÉå 02 ªÀÄvÀÄÛ 04gÀ°è CªÀ±ÀåªÁV £ÀªÀÄÆ¢¸ÀĪÀÅzÀÄ.

Address should be written by the candidate on page no. 2 and 4 compulsorily.

4. ¥ÀæxÀªÀÄ ªÀUÀðzÀ°è ¥Àæ±À¹Û ¸À»vÀ ¥ÀqÉzÀ ¸ÁÜ£À, ¥ÀæxÀªÀÄ ªÀUÀð, ¢éwÃAiÀÄ ªÀUÀð CxÀªÁ ¸ÁªÀiÁ£Àå (vÀÈwÃAiÀÄ) ªÀUÀðzÀ°è ¥Á¸ÁzÀÄzÀPÉÌ PÀæªÀiÁAPÀ 5gÀ JzÀÄjUÉ £ÀªÀÄÆ¢¸ÀĪÀÅzÀÄ.

Write “First Class with Distinction, First, Second or Pass” as the case may be against item No. 5.

¥ÀzÀ«, ¸ÁßvÀPÉÆÃvÀÛgÀ ¥ÀzÀ« ºÁUÀÆ r¥ÉÆèêÀiÁUÀ½UÉ ¸ÀA§A¢ü¹zÀ ¥ÀæªÉñÀ ±ÀĮ̪ÀÅ F PɼÀV£ÀAwzÉ:

Following are the Fees for issue of Original Degree Certificate of all the Degree and Diploma Courses :

1. J®è ¤AiÀÄ«ÄvÀ ¸ÁßvÀPÉÆÃvÀÛgÀ, ¸ÁßvÀPÉÆÃvÀÛgÀ r¥ÉÆèêÀiÁ ºÁUÀÆ gÁåAPÀ «eÉÃvÀ ¥ÀzÀ« C¨sÀåyðUÀ¼ÀÄ ¸ÀªÀÄPÀëªÀÄ ¥ÀzÀ« ¥ÀqÉAiÀÄ®Ä (¥Àæ¸ÀÄÛvÀ ±ÉÊPÀëtÂPÀ ªÀµÀðzÀ°è GwÛÃtðgÁzÀ «zÁåyðUÀ½UÉ ªÀiÁvÀæ

Rs. 1000/-

In person-all regular U.G., P.G./P.G. Diploma Certificate candidates & Rank Holders in Bachelor Degrees candidates (Current year successful candidates only)

2. J®è ¸ÁßvÀPÉÆÃvÀÛgÀ, ¸ÁßvÀPÉÆÃvÀÛgÀ r¥ÉÆèêÀiÁ ºÁUÀÆ ¸Ànð¦PÉÃmï ºÁUÀÆ ¥ÀzÀ« C¨sÀåyðUÀ¼ÀÄ C£ÀÄ¥À¹Üw ¥ÀzÀ« ¥ÀqÉAiÀÄ®Ä (ªÀiÁvÀæ)

Rs. 1500/-

In Absentia- P.G./P.G. Diploma Certificate and Bachelor Degree candidates only

1. G¥À¹ÜvÀ - ¸ÁßvÀPÉÆÃvÀÛgÀ «zÉò «zÁåyðUÀ½UÉ ªÀiÁvÀæ

2. C£ÀÄ¥À¹ÜvÀ J®è ¥ÀzÀ«AiÀÄ «zÉò «zÁåyðUÀ½UÉ ªÀiÁvÀæ

3. «zÉò «zÁåyðUÀ½UÉ WÀnPÉÆÃvÀìªÀ Cfð ±ÀÄ®Ì

(i)

In person PG foreign students only

100/- USD

(ii)

In Absentia for all U.G. Courses Foreign students only

150/- USD

(iii)

Application fees for Foreign National Students

25/- USD

«±ÉõÀ ¸ÀÆZÀ£É :

*1. «zÉò «zÁåyðUÀ¼ÀÄ ±ÀÄ®ÌzÀ ºÀtªÀ£ÀÄß qÁ®gÀUÀ½UÉ ¸ÀªÀÄ£ÁzÀ ¨sÁgÀwÃAiÀÄ gÀÆ¥Á¬ÄUÀ¼À°è ¥ÁªÀw¸À§ºÀÄzÀÄ.

2. WÀnPÉÆÃvÀìªÀzÀ ±ÀĮ̪À£ÀÄß ZÀ®£ÀzÀ°ègÀĪÀ PÉÆÃqÀ

PÉÌ ¨sÀj¸ÀĪÀÅzÀÄ.

3. AiÀiÁgÀÄ ¥ÀzÀ« ¥ÀæªÀiÁt¥ÀvÀæUÀ¼À£ÀÄß ¸ÀªÀÄPÀëªÀÄ ¥ÀqÉAiÀÄ®Ä Cfð ¸À°è¹ WÀnPÉÆÃvÀìªÀzÀ ¢£ÀzÀAzÀÄ ¥ÀzÀ« ¥ÀæªÀiÁt¥ÀvÀæªÀ£ÀÄß ¥ÀqÉAiÀÄ¢zÀÝ°è CAxÀªÀgÀ£ÀÄß UÉÊgÀºÁdj (C£ÀÄ¥À¹Üw) C¨sÀåyðUÀ¼ÉAzÀÄ ¥ÀjUÀt¸À¯ÁUÀĪÀÅzÀÄ ªÀÄvÀÄÛ CAxÀªÀgÀÄ C£ÀÄ¥À¹ÜwAiÀÄ ±ÀĮ̪À£ÀÄß vÀÄA§¨ÉÃPÁUÀĪÀÅzÀÄ.

Special Instructions :

*1. The foreign students can pay the equivalent amount of fees in Indian currency.

2. Those who use the challans need to remit the convocation fee to Code No.

3. The persons who have applied for conferring of the degree certificate in person but did not obtain his/her certificate on convocation day, will be treated as in absentia and they will have to pay absentia fees.

PÀZÉÃjAiÀÄ°è ¨sÀwð ªÀiÁqÀĪÀzÀÄ :

To be filled in by the Office

1. ¥sÀ°vÁA±À ¥ÀæPÀn¹zÀ ¢£ÁAPÀ :

Result declared on:

Date

Month

Year

2. WÀnPÉÆÃvÀìªÀzÀ CfðAiÀÄ£ÀÄß ¥Àj²Ã°¹zÀªÀgÀÄ :

Convocation application verified by

From :

The Registrar (Evaluation) Karnataka State Law University, Navanagar, Hubli Karnataka-India

C¢üÃPÀëPÀgÀÄ, ¥ÀjÃPÁë «¨sÁUÀ

O. S. Examination Branch

¸À»/ Signature…………………….

ºÉ¸ÀgÀÄ/ Name

Candidate’s address for dispatch of degree certificate (in capital letters)

O.I.G.S. Karnataka State Law University, Navanagar, Hubli

To,