MAKHANLAL CHATURVEDI NATIONAL UNIVERSITY OF JOURNALISM &

COMMUNICATION, BHOPAL
Application for issue of correctied Marksheet-after correction of Name/Surname

To,
The I/C Dy. Registrar (Exams)
MCNU of J&C, Bhopal
E-8 Trilanga, Shahpura,
Bhopal – 462039

Sir/Madam,
I request you to kindly name correctied marksheet. Necessary fee of Rs. ............. is
remitted through DD No. Date ................ Name of Bank ..................

1. Full Name
...........................................................................................................
(in English Capital Letters)

2. Full Name ...........................................................................................................

(in Hindi)

3. Father's Name ...........................................................................................................

(in English)

4. Mother's Name ...........................................................................................................

(in English)

5. a) Examination Passed ...........................................................................................................

b) Year ...........................................................................................................
c) Roll Number ...........................................................................................................
6. Enrollment Number ...........................................................................................................
7. Study Centre Code ...........................................................................................................
8. Study Centre Name ...........................................................................................................
Place ...........................................................................................................
Date ...........................................................................................................
Complete address in capita letter with Pin Code
.................................................................................................. Your's Faithfully
..................................................................................................
..................................................................................................
Phone No. With STD Code ..................................................... Signature of Student

Note: - Attach following documents with this form: -

a) Original Marksheet.
b) Attested photocopy of 10+2 Marksheet.
c) D.D. of Rs. 50/- (Per Marksheet) + (Postal Charge Rs. 20/-)
d) Original Affidavite on Rs. 10/- Stamp paper (Only for Surname change)