PGIHS/GNE/FORM/003
POSTGRADUATE INSTITUTE OF
HUMANITIES AND SOCIAL SCIENCES (PGIHS)
University of Peradeniya
Academic Transcript Request Form
1. Name of the Applicant: Rev./Dr./Mr./Miss/Mrs.
2. Address:
3 Telephone No.:
4. email:
5. Registration No.:
6. Degree Programme followed:
7. Field of Study
8. Payment of Transcript fee: Amount:
Date:
9. Purpose of Transcript request:
10. Address of the Institute to which the
transcript be posted/ faxed/ emailed: (State
clearly address, contact and fax numbers
and email address of responsible officer)
12. Claim by the Applicant: Please post/fax/email (delete appropriately) my transcript to the
address of the receiving institute given above.
Signature of Applicant:
Date:
13. To be Completed by Relevant Subject Clerk:
Degree Programme followed by the Applicant:
Field of Study:
Date of Completion of Coursework (if relevant):
Date of Completion of Dissertation/ Thesis (if relevant):
Effective date of the Degree:
Receipt of Transcript fee: Yes / No
Any other remarks:
Signature of Subject Clerk:
Date:
14. Recommendation of Assistant Registrar/PGIHS
I recommend/ do not recommend the issue of the transcript.
Signature of AR/PGIHS:
Date:
15. Approval of Director /PGIHS
Approved / Not Approved.
Signature of Director/PGIHS:
Date:
PGIHS/GNE/FORM/003
Notes for Applicants
✓ Transcript Fee is Rs. 1000.00 if the transcript is to be sent to a local institution and Rs. 1500.00 if the
transcript is to be sent to a foreign institution.
✓ Transcripts are sent only to Universities, Ministries, Embassies or any other Recognized Institutes,
Transcripts are not issued directly to the applicant as they are of confidential.
✓ Along with Payment Voucher of Transcript fee, duly completed application form should be sent to:
Assistant Registrar,
Postgraduate Institute of Humanities & Social Sciences (PGIHS),
University of Peradeniya, 20400 Peradeniya,
Sri Lanka
Tel: (+94) 081 2068361
Fax: (+94) 081 2068362
Email: info@pgihs.lk