RAJIV GANDHI PROU0YOGIKI VISHWAVIDVALAYA, BHOPAL
(--~~\ (Univer~ity of Technology of Madhya Pra desh)
~"'_~ Airport Bypass Road, Gandhi Nagar
.~ Bhopal-462036
Application Form For Issue of Migration Certificate
To be filled by the office
To, MlcratJonHo - --··--- ..·~····-·-·-·-... ---·-
The Registrar, o1spatch No ······-··-···- ·- ·-·······-···--·---·-··-
Rajiv Gandhi Proudyogi ki Vi shwavidyalaya oate ·---·--·-·-·--~-•--"·-·- ··..............
Bhopal. Oealln& Asstt.
Sir
I have been a student of this Vishwavidyalaya studlng as r.e.~ar/Ex student in the ... S.h.~................
Yru.~hl'.\~v...IY.l.S.:h.iY..k..Qf.Ie.:.4 .:no.lA~~eg~~ ~~'Jfe~Aa~Yr1~~ti~he Month
and Year ..I~".'.\t.... . . in ...F.i~.t......... Division. I req uest you to kindly issue me Migration
Certificate.
The necessary fee Rs ...................... !..?..9../..::-:........................ ........ ............ has been deposited in Bank
2.
Full Name is English(ln ~ , mettezj ,·lNsA~Hl. . .Tt.A.G:I.I ....................................................
Draft/ Challan (Challan o nly UBI) No. ......, .................................. Of Bank ...................... ............ Dated ...... ............ .
1.
Full Name in Hindi ...................... ( .......... ....................................................................................................... .
3. Father's Name ...... $.J'.\Rl. ..... A.RV.N...TtA.~ .I.................................. .......................................... .
4. Examination last appeared/passed ......t'.\.f;: ................ Year ..... ?.:.~.!.~............ Division .... f.\.R.~.1. .. .
S. Marks obtained in last semester .C§i.f.'.A ...9:..QQ... Out of .............................
6.
7.
8
Grand total
Branch .. Eml>.~.~d.t.\/.9)
. . ~.~.....i·r '·.& ..
Name of lnst1tut1on.Sh..... . DY.J..0.Y...
08.
(Including weig~t~e) k....... iQ............. ~ t 1.>f ....~9..................
Y .l,S,~EnrqtM!hl No ...... 0 ..
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9. Student Email ID ........P,A.Q.~ !.. .. ~MCU.l.:..~ f,atsApp No. ... iS.~.S..3. .....1.J..S 1
Date: .. 'l.o.(.O.'i./.2.o2 \ LJ You rs Faithfully,
Place :q .~ .O.A.. Phone/Mobile No ... g..§.~.~.~..'.'.T'!_~:}, Sigi f ~tudent
CERTIFICATE TO BE RECORDED BY THE PRINCIPAL/HEAD OF THE INSTITUTION
Certified that the eligibility fo r award of Migration certificate has been checked with the original of the
concerned certificates, marks sheets, office record of the institution and found correct. The candidate
may be issued the desired certificate.
Signature and seal of the Principal/Head of the Institution
Important Instructions;
1. For Migration Certificate please enclose copies ofi the Final semester/Year Marksheet and T.C. attested
by the concerned Principal/Head of the Institution. Postal Address must be filled twice in given box.
2. Applicant can authorize someone to obtain Migration Certificate by giving him authorization letter &
original Marksheet /T.C./Student Identification proof also Authorized person must have his
identification proof also.
3. Demand Draft is payable in favor of Registrar, Rajiv Gandhi Proudyogiki Vishwavidyalaya, Bhopal.
4. Fees: Rs. 150/- Bank Draft/ Challan{Challan only UBI).
Postal Address:
Name ...... PB.A~H.f.....T't. AJb:L......... ... . . ... Name ........ . EBf.\.~H.~ ....TXA.~.l.. . ... . .
Address ... \,,;:.?......,M.~..P..H.Y...BAN............ .. Address .. l:.:?..M.A.PH.Y.B..A.N. ............ .
....EN.C..I..A.V..6 .)" .... A.~ . .P..l!.R.t. t · .EN<..\A.~.e...t .A'l.J!(A..fV..KI...') . ......
.....C.r:t.':t ..... L.€..t:l.!.R e..,..... B.~tU.NC. ... NE-t.v ....C.tr..'::(.....c.e.~.1.B..~.t o.P.;;,,€;nt.N.D
. .HlaH ........ (Q.v..R'.f.. , ..4.~A.\.1..0.Is....... . . . N~w..... ttIG .t.l ...... . ...~.f.J. ..f.'-t~Au pe.
PIN code ......... 4.J... . 0.0 .)................................... . PIN code ...........~ ]
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