COE Form-3
North South University
Application Form for Official Transcript
To
The Controller of Examinations
North South University
Sir,
Please issue my Official Transcript as follows:
a. One copy/……….... copies addressed to myself.
b. One copy/………… copies against the following address or addresses shown in the attached paper
(Please write in CAPITAL letter).
______________________________________________________________
______________________________________________________________
Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ID#_ _ _ _ _ _ _ _ _ _ _ _ _ Date of birth: _ _ _ _ _ _ _ _ _ _
(Please Write in CAPITAL letter)
Program: _ _ _ _ _ _ _ _ _ _ _ _ Major-1:_ _ _ _ _ _ _ _ _ _ _ Major-2_ _ _ _ _ _ _ _ Minor: _ _ _ _ _ _ _ _ _ _
Cell No: _ _ _ _ _ _ _ _ _ _ _ _ e-mail: _ _ _ _ _ _ _ _ _ _ _ Signature of the Student with date: _ _ _ _ _ _ _ _ _
(Transcript fee Tk.300/- per copy)
For clearance of NSU Accounts For Library clearance
Signature with date & Seal: Signature with date & Seal:
FOR OFFICE USE ONLY:
Signature of the receiving Officer with date: _ _ _ _ _ _ _ _ _ _ _ _ _ Please collect the document on: _ _ _ _ _ _ _ _ _ _ _
Student’s Part for “Official Transcript” (to be filled by student):
Name of the Student: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Office Seal
ID# _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
__________________________
Signature of the Student with date
N. B. 1. Please enclose photocopy of your SSC/ ‘O’ level/ Equivalent Certificate and pay Tk.300/- for each copy at Bank [United
Commercial Bank Limited (UCB), Bashundhara Branch, Dhaka (beside GP House)]. 2. NSU Accounts & Library clearance
is not required for the graduates.
*The requested document will be destroyed if the applicant does not receive it within three months from the date of delivery.
Official Transcript