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This is to certify that the student has taken admission on ...................(date) ........... (month)…..............(Year).
(1st / 2nd/ 3rd/ 4th year) of .............................. (Name of course 11th/ 1st year of 2 years ITI Course / Engineering degree
/MBBS /MBA) and the information given above is correct as per records of our institute. Certified that he / she is not in
receipt of any other scholarship from any other source. The institute shall inform IOCL in case the student accepts any
other scholarship from any other source.
Postal Address of School / College/ University/ Institute: Signature & name of Head/Dean / Principal of
School / College/ University/ Institute with date
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State:………………………………….Pin………………….. Seal of School / College/ University/ Institute