Flood in Assam

Form No. Regn.-03

Assam Higher Secondary Education Council Bamunimaidam, Guwahati-21 APPLICATION FORM FOR MIGRATION CERTIFICATE 1. Name in full [in Block Letters] 2. Father’s Name & Home Address : : ……………………………………………………….. ……………………………………………………….. ……………………………………………………….. ……………………………………………………….. 3. AHSEC Registration Certificate No. 4. Examination Results Examination passed HSLC HS (Arts/Sc./Com) Name of the Board/ University Examination Roll & No. Year of passing Division / Class : ………………………………………………………..

5. Name of the College/School where studied last

:

………………………………………………………

6. Name of the Institution [outside Assam] : where he/she is studying now/ intending to study

……………………………………………………… ………………………………………………………

7. Course ……………………………………….. Class ……………………………. Roll No. ………….. 8. Cause of obtaining the Migration Certificate 9. Migration fee Amount paid Rs. 100/Council’s Challan No. & date or Crossed Bank draft No. & Date : ………………………………………………………..

10. Address to which Migration Certificate should be sent …………………………………………….. …………………………………………….. 11. I declare that I have not been debarred from appearing in any Examination or prosecuting any course of studies by the Council. 12. I surrender my Original Registration Certificate bearing No. ………………….. of ………………. Date ……………………. Signature of the Applicant Cont….

RECOMMENDATION OF THE PRINCIPAL
The particulars stated above have been checked, verified and found correct, Migration Certificate may be issued.

Memo No………………………

Date …………………

Signature of Principal with seal

1. An applicant who applies for issuance of a Migration Certificate should pay FEE of Rs.100/- [Rupees one hundred] only and submit the application THROUGH THE HEAD OF THE INSTITUTION in which he/she is prosecuting or prosecuted his/her studies last. 2. Migration Certificate is issued only to a registered student of this Council. Registration Certificate issued by the Council should be SURRENDERED for the purpose. 3. No