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CLC Form

This document is an application form for students of Marwari College, Ranchi to request a character certificate. It requests basic student information like name, date of birth, program of study, registration number, and examination details. It also includes a declaration by the student that the information provided is true. The bottom section is for office use only to record the certificate number, date, and signatures of approving authorities. The character certificate is used to provide proof of character and academic performance for purposes of higher education, jobs, or other needs.

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siddharth tiwary
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© © All Rights Reserved
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Download as PDF, TXT or read online on Scribd
362 views

CLC Form

This document is an application form for students of Marwari College, Ranchi to request a character certificate. It requests basic student information like name, date of birth, program of study, registration number, and examination details. It also includes a declaration by the student that the information provided is true. The bottom section is for office use only to record the certificate number, date, and signatures of approving authorities. The character certificate is used to provide proof of character and academic performance for purposes of higher education, jobs, or other needs.

Uploaded by

siddharth tiwary
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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MARWARI COLLEGE, RANCHI

(AN AUTONOMOUS CONSTITUENT UNIT OF RANCHI UNIVERSITY)


(COLLEGE WITH POTENTIAL FOR EXCELLENCE SELECTED BY UGC)
Website : www.marwaricollegeranchi.ac.in E-mail : [email protected], Ph : 0651- 2213545

APPLICATION FOR C.L.C / CHARACTER CERTIFICATE


S.No……………………… Date: …………………………….

Please issue ( ) Character Certificate ( ) College Leaving & Character Certificate


For Purpose ( ) Higher Education ( ) Selection In Job ( ) Other Purpose
1. Student Name (English):

2. Student Name (Hindi): …………………………………………………………………………………………….


3. Father’s Name:

4. Mother’s Name :

5. D. O. B :
6. Permanent Full Address:
V I L L -
P O - P S -
D I S T P I N -

7. State.

8. Programme:
U.G :- B.A (H) ( ) / B.Sc. (H) ( ) / B.Com (H) ( )…………………………………….……………

P.G :- M.A ( ) / M.Sc. ( ) / M.Com ( ) ………………………………………………………………

MCA ( ) / M.Sc. BioTech ( ) / MBA ( ) / F.D . ( ) / Amanat ( ) / DPFM ( )

9. Reg. No. Class Roll No.

10. Exam. Roll No. Session:

11. Last Exam Name: ……………………………………….…Passing Year ………………… Division: …….......


Declaration:- I hereby declare that all the information given above is true to the best of my knowledge and belief. I shall
be held responsible for any false / fake information.

Signature of Students…………………………………..
NO DUES CERTIFICATE
1.Fee Paid Up to.…………………………………………………………… 2.Challan No………………....…………3. Counter Sig………………………
4. LAB ………………..…………………………………….5. NCC ………………………..……………….. 6.Library …………………………………………..…
7. Voc.Lib……………………..…… 8. Examination ………………………………….……9. Sports….….........................................................
………………………………………………….…………………………FOR OFFICE USE ONLY……………………………………………………………………….
Date:…………………………………….. C.L.C No. …………………………………………………Registration No. ………………………………………….
p

Assistant. ……………………………………H. Assistant …………………………………Principal/Prof. In_Charge/DSW ……………………………

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