Form M(O)

University of North Bengal

P.O. North Bengal University, Raja Rammohunpur,

Dist. Darjeeling, PIN 734013

Application Form for Migration Certificate

1. Registration Number with the session: (Original Registration Certificate without lamination is to be enclosed):
2. Name of the applicant (in block letters)
3. Mother’s Name
4. Father’s Name
5. Address for Communication
6. Name of the College / Department under this University where the student studied last:
7. Last Examination passed from this University. (Attested photocopy of marksheet is to be enclosed.)		Year
		Roll
		No.
8. Reasons for Migration :
9. Fees (may be deposited in cash at the University Cash Counter between 11 a.m. to 3 p.m.	1.*Urgent – Rs.550/- (Migration Certificate to be issued by hand on the same day) 2.* Ordinary – Rs. 350/- (Enclose self-addressed envelop with required postage-stamp for sending Migration Certificate by Registered Post) The payment is to be made by Bank Draft drawn in favour of “University of North Bengal” payable at SBI, NBU Campus Branch.
	Bank Draft No. & Date
Signature of the Student			Signature of Principal (in case of College) / Head of Department (in case of University)/Registrar with Seal
Date			Date

* Applicable for Migration Forms downloaded from the website (www.nbu.ac.in)

The filled-in form should be sent to the Registrar, University of North Bengal, P.O. North Bengal University, Dist. Darjeeling, PIN 734013.

N.B. – (1) The Migration Certificate must be returned within a period of one year from the date of issue, in case this is not used for the prescribed purpose, failing which the Duplicate Migration Certificate, if asked for, shall not be issued.

(2) Incomplete Application Form may be rejected.

(3) Fees once deposited shall not be refunded.