RAJASTHAN TECHNICAL UNIVERSITY

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Phone: +91-0744-2473014, 2473106, 2473063, 2473861
APPLICATION FOR MIGRATION CERTIFICATE
COURSE: B.Tech. M.Tech. MBA MCA BHMCT B.Arch. MAM

Roll No……………………………… Enrollment No……………………………….Branch……..…………

Name…………………………………………………………...……………………..…………………………..
Father’s Name………………………………………..…………….……………………...…………………….
Mother’s Name………………………………………………………….……...…………..……………………
College……………………………………………………………………….………...…………………………
Choice For Delivery of Document (Please Tick  Mark) :- College Residence
Home Address :-…………………………..…………………………………………………………………...
………………………………………………………...…………………………………………………………..
…………………………………………………………………………………Pin Code……………………..

PAYMENT DETAIL:- Challan/DD No………………………………...……..…Date……………….……….

Bank Name………………………………………..………....……….…….………Amount……………….……
Check List :
1. Photocopy of Consolidated Marksheet & Provisional Degree Mobile No.
2. Photocopy of Personal ID E-Mail ID
3. Demand Draft of Rs. 250/- in favour of Rajasthan Technical University, Kota payble at Kota in
original.
4. Photocopy of Residence Proof (If delivered at residence)
5. One A4 size self addressed envelope Signature of Candidate with full name

Note :- 1. All attached photo copies of documents should be self attested and properly legible, otherwise
document(s) will not be prepared.
2. Internet mark sheets are not acceptable.
3. In case of any wrong information provided in the form, candidate will be fully responsible for the
same and University may take appropriate action against him.

For Office use only

Reference No. ……….……… Date……..……… Dispatch No……..………… Date……...……

Address :- Office of the Controller of Examination, Rajasthan Technical University, Rawatbhata Road,
Kota-324010