VINOBA BHAVE UNIVERSITY HAZARIBAG Lea APPLICATION FORM FOR ISSUE OF : MIGRATION CERTIFICATE Name (In Block Letter) Name (in Hindi) Father's Name (In Block letter) Father's Name (in Hindi) Mother's Name(in Block letter) Mother's Name (in Hindi) Registration number of the University Year (Attested copy by the concerned Principal / Department of (i) Regn. Receipt, (ii) Marksheet, (ili) Admit Card, (iv) C.L.C. should be attached In proof.) Details of the examination passed or failed a) Name of the Institution b) Roll (Code) Examination Roll No, ©) Name ofthe Examination @) Passed Division/ Class Year ©) failed Year ) Date of Leaving the Institution reported of debarred for use of unfairmeans at the last examination, please give the following details ~ Examination Roll No Centre 3 . Year Ifa Private Candidate, give the following details, Examination Roll No Centre Year 10, Date Challan No. of Migration Fees 2 Date ‘Amount of fee paid : Rs. PermanentAddress PresentAddress 20 Signature of the Applicant 1" Date :.. Certified that the applicant was a regular student of this institution and there is nothing againast his/ her character. Migration Certificate may be issued. Signature of Head of the Institution 20 and Seal