Provisional Degree/Migration Certificate - Samrat Ashok ...

SAMRAT ASHOK TECHNOLOGICAL INSTITUTE (ENGG. COLLEGE) (An Autonomous Institute Affiliated to RGPV, Bhopal) Vidisha (M.P.) 464001

Application for Issue of Migration/Provisional Degree Certificate To be filled by the officer Migration/Provisional Certificate No................................................ Despactch No............................................... Date .............................................................. Dealing Asstt.

To, The Director S.A.T.I. (Engg. College) Vidisha Sir

I have been a student of R.G.T.U., Bhopal studying in Regular/Ex student in the Samrat Ashok Technological Institute (Engg. College) Vidisha (M.P.) and Passed the examination in the Month and Year ………… …………………..in………………….Division. I request you to kindly issue me Migration/Provisional Degree Certificate. The necessary fee Rs.….............................................…........………………………has been deposited in Bank Draft No. …………………………………. of Bank ………………………...............……………dated…………….............. 1.

Full Name in English (In Capital Letters)………….........................................................………………………………

2.

Full Name in Hindi ……………………..………………………………………………………………………………………

3.

Father's Name …………………………….…………………………………………………………………………………

4.

Examination last appeared /Passed …….....................…………Year………...........……Division............................

5.

Marks obtained in 8th semester ................………………..out of ……………................CGPA ...............................

6.

Grand Total (including weightage) …………………………..out of ……………...................CGPA ...............................

7.

Branch ……………………………………………………………..................................................................................

8.

Name of Institution ……………………………………………………………………………………………………………

Date :………………….

Received Degree

Address :……………………..........…....

No…………....……………….

Your's Faithfully

…………………………………............... Pin : …………….Phone ………………..

(Signature of student)

(Signature of student)

Certificate to be recorded by the Dean Academic/Registrar of the Institution Certified that the eligibility for award of provisional /migration certificate has been checked with the original of the concerned certificate, mark sheets, office record of the institution and found correct. The candidate may be issued the desired certificate.

Note : * * * *

Signature and seal of the Dean Academic/Registrar of the Institution

For Provisional Degree please enclose a copy of the Final Semester /Year Marksheet attested by the Dean Academic/Registrar For Migration Certificate please enclose of copies of the Final Semester /Year Marksheet and T.C. attested by the Dean Academic/Registrar. Demand Draft is payable in favour of Director, Samrat Ashok Technological Institute (Engg. College) Vidisha Fee:Migration Rs. 150/Provisional Rs.150/Postal Charge Rs. 50/-extra Postal Charge Rs. 50/- extra Note : Please use separate form for each certificate