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UGC - NATIONAL ELIGIBILITY TEST DECEMBER, 2011 Print Copy of Application Form
(TO BE SUBMITTED TO THE TEST CENTRE IN DUPLICATE)

To be
Roll No. 46080419

Osmania University, Hyderabad UNIVERSITY TEST CENTRE Subject Code Centre Code 08 46

1. 2. (i) 2. (ii) 3. 4.

Appli

Post Gradu Examin

Subject of Gradu

Subject opted for

Centre of Examin

5. 6. (i)

Name (as per Hr Matriculation Certi

Date of Birth (as rec in matriculat equivalent certif

7.

Whether relaxation is 8. 9.

Cat

Visually Handic (V/H) / Phys Handicapped Father's Mother's

10. (i) 10. (ii) 11.

Addre Communi

12.

Permanent Ad

Affix recent Passport size Photograph signed by the candidate and duly attested by the Head of the Deptt./Institution or Class I Gazetted Officer (DO NOT USE STAPLER

OR PIN)

Detail of Educational Qualification

13. (a) 13. (b) 13. (c) 13. (d) 13. (e) 13. (f) Examination M.Com. Appearing/Passed : Name of the University : Year of Passing : Subject Offered : Specialization ( if any ) : Marks/Grade : Telangana University 2010 COMMERCE E COMMERCE Marks Passed Ph. D.: No

Mark Obtained : 1322 Total Marks : 1900 % of marks obtained : 69.58%

14.

Detail of Fee Deposited

Name of the Bank Name of the Branch Branch Code Journal No. Deposit Date Amount : : : : : : STATE BANK OF INDIA Moosarambagh 10328 005015046 21-10-2011 Rs. 225

15.

The State/UT which you : Andhra Pradesh(01) belong

Place: Date:

Hydrabad 21-10-2011

Phone No. (with STD Code) Mobile No.: 9666609036

Email:

nsvasu500@gmail.com

Declaration
i) I, N SRINIVAS, hereby declare that all statement made in this application are true, complete and correct to the best of my knowledge and belief and in the event of any information being found false or incorrect or any ineligibility being detected before or after the test, my candidature is liable to be cancelled and legal action may be initiated against me. ii) I fulfill all conditions of eligibility regarding age limit, educational qualification etc. prescribed for the test. iii) I have gone through the conditions attached to NET and shall abide by the same. iv) I have deposited the required fee. v) I have noted that if my application is found incomplete/defective, the same is liable to be rejected summarily and no correspondence will be entertained in this regard. vi) I have read and agree with the Notification for the UGC NET including instructions, enclosures, check list and other relevant information.

Signature of Candidate________________