RAJENDRA UNIVERSITY
PRAJNA VIHAR, BALANGIR – 767002 (ODISHA)
FORM OF APPLICATION FOR ISSUE OF MIGRATION CERTIFICATE
[To be filled by the student concerned]
From: _____________________________________
_____________________________________
_____________________________________
Name in full with complete address
To,
The Registrar
Rajendra University
Prajna Vihar, Balangir
Through the Principal ________________________________________________________
(only for Regular Student)
Sir,
I would request you kindly to issue a Migration Certificate in my favour, as I intend to join the
__________________________________________________________ University for my further studies. I
passed/failed the ______________________________________________________________ Examination of the
Rajendra University held in the month of ________________ with Roll No. ___________________ from the College
___________________________________________________ or I am at present reading in
______________________ Class in ___________________________________________________ College, P.G.
Department in ____________________________________________ College.
I passed/ failed at the __________________________________ Examination of the Rajendra University held
in the month of ______________________ with Exam. Roll No. ________________ a Non Collegiate Candidate.
I have paid a fees of Rs. 200/-(Rupees two hundred only) in shape of B.D. /University Cash Receipt No.
_____________________ Dated _________________.
In the circumstances, I request that the Migration Certificate prayed for may kindly be issued to me at your
earliest convenience.
At the first instance, I registered my name in this University as a regular student through ________________
________________________________________________ College __________________________ and enclosed the
Registration Card in Original with this application for necessary action at your end.
Attested I beg to remain Sir
Signature of the Gazetted Officer Yours faithfully,
(with Office Seal)
(For Non-Collegiate Candidates only)
Signature in Full
N.B. Please strike out the words not required. Date: _______________
RAJENDRA UNIVERSITY
PRAJNA VIHAR, BALANGIR – 767002 (ODISHA)
(Information required for issue of Migration Certificate)
(To be filled by the institution recommending the application)
1. Name of the College ________________________________________________________
2. Name of Student ______________________________________________
3. Examination passed with year and Roll No. or if he/she is still a student of the institution state the
class in which he/she is reading ____________________________________________
4. Whether the fee of Rs. 200/- has been paid to the University direct or credited to the University
account in the State Bank of India, ADB Branch, Balangir (receipt should be attached)
________________________________________________________________
5. Date of birth as in the College Admission Register ____________________________
6. Date of first Admission to college under the University after passing the Matriculation, HSC or CBSE
any other examination _____________________________
7. Registration No. _______________________.
8. Date of leaving the college _______________________________
9. Conduct and Character of the student during his/her College career __________________________
_________________________________________________________________________________
10. Opinion of the Principal as to the University’s granting the application a Migration Certificate
_________________________________________________________________________________
11. Degree or course the student wants to take in the University he/she wants to join
_________________________________________________________________________________
Memo No. ___________________________, Dated _______________________
Forwarded to the Registrar, Rajendra University, Prajna Vihar, Balangir together the application of
issue of Migration Certificate in original for necessary action.
PRINCIPAL
College
(With Official Seal)
N.B.
1. Application, incomplete in any manner will not be attended to and no correspondence will be
initiated in the matter.
2. Original Money Receipt/ BD and Registration Card must be attached with this application.
