MICROTEK COLLEGE OF

MANAGEMENT AND TECHNOLOGY

(Associate Study Center of Punjab technical University, Jalandhar)

Centre Code:-_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Nirmal Complex, Maldahiya, Varanasi- 221001

SCHOLARS REGISTER AND TRANSFER CERTIFICATE

FORM
ENROLMENT NO.

:...................... TRANSFER CERTIFICATE NUMBER

1.

ADMISSION NO

:..

2.
3.

.
SCHOLARS NAME
MOTHERS NAME

4.

...
FATHERS NAME
:.

5.

..
ADDRESS

6.
7.
8.

.
GURADIANS NAME :...
TELEPHONE
: RESI OFF. .....
DATE OF BIRTH
: DATEMONTHYEAR..

9.
10.
11.

...
SC / ST / OBC
:SEX (M / F )...
NATIONALITY
:RELIGION: .....
NAME OF THE SCHOOL LAST ATTENDED :

12.

T. C. SUBMITTED
:BIRTH CERTIFICATE SUBMITTED .

: ..
:

:..

.
CLASS

DATE OF
ADMISSION

DATE OF
PROMOTION

DATE OF
REMOVAL

CAUSE OF
REMOVAL

YEAR

CONDUCT AND
WORK

Certified that the above Scholars register has been posted upto date as required by the
Department rules.

HEAD OF THE
INSTITUTION

Signature of the Father or Guardian receiving the T.C.

SEAL
..........