Application form for Inter-University Migration [pdf] - University Forms

Panjab University, Chandigarh
Application for Inter-University Migration/copy
of entries from the Register of Students
(To be filled in by the applicant in his/her own hand)
A. Fee Remitted Rs.___________________________ Bank Draft/University Receipt
No._______________ Date __________________
B. Name: (In capitals)
Fee Code R0040
Website: http://forms.puchd.ac.in
Case No._____________________
(For Office Use)
Father’s Name: (In capitals)
Mother’s Name: (In capitals)
Registration No.
Institution where studying presently ________________________________________________
Class ________________ University to which Migration is sought __________________________
_______________________Reasons for Migration ______________________________________
______________________________________________________________________________
C.
Last examination of this University in which appeared/passed:
Examination _____________ Year/Session__________ Roll No. __________ Result__________
Institution/District (For Private Candidate ___________________________________________
______________________________________________________________________________
D. I solemnly declare that:
(i) All the particulars given by me are correct; (ii) I have passed Matriculation/Higher Seconday
Examination of Panjab University but I did not join any College affiliated to this University. (For
applicants who are not registered students).
Address
___________________________________
___________________________________
___________________________________
CERTIFICATE NO. 1
_____________________________
Signature of Applicant
AFFIDAVIT
(For applicant who are/were on rolls of affiliated
College/Departments of Correspondence Studies
and leaving the course without completing)
I have no objection to the issue of University Migration
Certificate to the Applicant
For duplicate Migration Certificate please
attach an affidavit duly attested by Ist Class
Migistrate stating therein :-
That the Migration certificate earlier issued
to me has been lost and has not been used
by me to seek admission anywhere.
Signature of Principal/Chariman
Dept. of Correspondence Studies
Dated: ____________
Official Stamp
ATTESTATION (Regular Student /Private Candidates)
Last Exam:____________
I certify that the applicant __________________________ son/daughter of Shri _______________
___________________ is the Same person who signed in my presence under the particulars on the
enclosed form.
Name, designation and address of the
attesting authority
______________________________
______________________________
______________________________
Signature of attesting authority
Dated ______________________
____________________________
Offical Stamp
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Website: http://forms.puchd.ac.in
Attesting Authorities:
(i) College/University : Principal of the College/Chairman of the Deptt.
Teaching Deptt.
Concerned.
Candidates.
(ii) Private Candidate : A Gazetted officer, Principal of an affiliated College,
Chairman of the University, Teaching Deptt, a
fellow of University. University Officer not below
rank of Asstt. Registr!r
FOR OFFICE USE
Particulars verfied vide Gazette/According to Register of students
Allowed /Not Allowed
ORDERS
Asstt. Suptd. A.R. (R & S)
(To be filled by the Candidate)
Address
Address (For despatch of Certificate)
Name(In Capitals):_________________________
Address: _________________________________
________________________________________
Name(In Capitals):_______________________
Address: ______________________________
_____________________________________
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