FORM - F
GOVERNMENT OF GOA
BOARD OF TECHNICAL EDUCATION
Alto, Porvorim - Goa
APPLICATION FOR ISSUE OF DUPLICATE MARKSHEET
1. Name of the Student:_______________________________________
2. Address: ___________________________________________________
3. Telephone No.: __________________
4. Institute where the student was studying: __________________________
___________________________________________________________________
5. Diploma Programme undergone: _________________________________
6. Enrol. No.: ________________
7. Month & year of passing:________________________
8. Is the mark sheet spoiled/lost: _______________
9. If spoiled, attach spoiled Marksheets.
10. Copies of document attached
a) Copy of mark sheet /Diploma.
Date: Signature of the candidate
Forwarding remarks from Institute:
Date: Seal Signature of the Principal
FOR OFFICE PURPOSE ONLY
Details of payment of Fees
Rs.200/-+ search fee.
Receipt No:
Date:
Cashier
Duplicate diploma issued
On:
Signature