Paste Attested Photograph

Application form for Issuance of

Provisional Certificate (PC) / Detailed Marks Certificate (DMC) / Additional Specialization Certificate (ASC)

Name of Candidate: _________________________________ Fathers Name: ______________________________ Roll No. ___________ Registration No. _________________ Programme _____________ Session _____________ Date of taking last examination ___________________________ Date of Viva/Presentation __________________ Title of Project ________________________________________________________________________________ Project fee remitted vide Demand Draft/Pay order/Cash Receipt No. ___________________ Amount ___________ Date __________________ PC/DMC/ASC Fee Deposited with the University Amounting to Rs. __________ Vide Demand Draft/Pay order/Cash Receipt No. _________________ Dated _______________ Tel./Mob. No. _______________________ Important Note: The prescribed fee for issuance of PC/DMC/ASC in shape of DD/PO should be drawn in favour of Mohi-Ud-Din Islamic University, Islamabad and payable at any bank branch of Rawalpindi/Islamabad. Rs. 200/- is normal fee and Rs. 400/- is urgent fee for issuance of PC/DMC/ASC. Attach attested photocopies of the following by Govt. Gazetted Officer Class I: (i) Matric Certificate (ii) Intermediate Certificate (iii) Bachelor Degree (v) Result Cards of MIU (vi) Others, if any Postal Address: Permanent Home Address: Signature of Candidate College/Institute Address: C.N.I.C. _______________________ You are requested to kindly furnish the following information:Employed/Not Employed __________________ Name of Organization/Department _________________________________ Date of Appointment ___________________ Designation _________________________________ Salary _______________ Postal Address/Tel. No.__________________________________________________ E-Mail _________________________

(iv)

C.N.I.C

No

Attestation by the Principal of the College / Institute

It is certified that
(1)

(2) (3) (4)

Mr. /Miss. ____________________________________________________ has been a student of this College / institute for the academic year / session _____________________________________________ The particulars given above are having been verified as correct. The applicant has been declared successful by MIU on _________________________________________ The candidate has cleared all the University dues and submitted the required documents.

Signature of Principal
(With Stamp)

NOTE: The candidate must attach last Certificate/Degree duly verified by the IBCC/HEC with application form as detailed below: (a) Bachelor Programs: Photocopy of HSSC duly verified by the IBCC. (b) Master Programs: Photocopy of Bachelor Degree duly verified by the HEC. (c) B.Ed Program: Photocopy of Bachelor Degree duly verified by the HEC. (d) M.Ed Program: Photocopy of B.Ed Degree duly verified by the HEC.