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CSIR-UGC JRF/NET E am

Online Application Form Joint CSIR-UGC Test for JRF and Eligibility For Lectureship, NET - 23-12-2012 [Council of Scientific & Industrial Research - HRD Group, Examination Unit]
1. R ollNo(To be fille d by O ffice O nly) 2. Application No.

12D650489
3. Applie d For 4. Subje ct 5. Ex am C e ntre 6. Me duim of NET Ex am (As applicable ) 7. C andidate Nam e 8. Se x 9. Fathe r/Mothe r/Husband Nam e 10. Date O f Birth 11. Age As O n 01-07-2012 12. C ate gory 13. Physically/Visually Handicape (PH/VH) 14. If VH, Do You W ant Scribe 's He lp : 01 - JRF : 6 - ENG - ENGINEERING SCIENCES : 02 - BHA - BHA VNA GA R : 02-ENGLISH : SA NZIRA VISHA L RA JESHKUMA R : MA LE : FA THER -> SA NZIRA RA JESH MA HA DEVBHA I : 29-09-1991 : 20 Y, 9 M, 3 D : GEN : NA : NA

15. W rite your nam e and com ple te Mailing Addre ss. Nam e : Addre ss : SA NZIRA VISHA L RA JESHKUMA R 35, A MBICA TENA MENT, NEA R ISA NPUR BUS STOP, ISA NPUR A HMEDA BA D 382443 GUJA RA T Signature of C andidate ------>

C ity: Pin : State :

16. Pe rm ane nt Addre ss 17. Em ail : vishalsanzira@gmail.com

18. Q ualifying De gre e

: B.E.

[Candidates enrolled for M.Sc. or having completed 10+2+3 years of qualifying examination as given in column 18, may apply under Result A waited (RA ) category] 19. If R e sult Awaite d 20. Ye ar O f Appe aring in Final Ex am (a) Ye ar O f Passing : NA 22. If e nrolle d in MS-PhD program (a) Ye ar of e nrollm e nt (b) Ye ar of passing bache lor de gre e (c) Division/Grade (d) Mark s O btaine d (%) : RA : 2013 A (If R e sult Awaite d) (c) Mark O btaine d (%) 0%

21. Give de tail of Final Ex am R e sult (If not R e sult Awaite d) (b) Division : : NO : NA : NA : NA :0

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CSIR-UGC JRF/NET E am
Application No: 23. Spe cialization : (a) Spe cialization C ode : 605 ENGINEERING 24(a) Unive rsity/Institute C ode (b) Unive rsity/Institute Nam e (b) Spe cialization Subje ct Nam e : ELECTRONICS A ND COMMUNICA TION : 999 : GUJA RA T TECHNOLOGICA L UNIVERSITY 12D650489

DECLA RA TION I, SA NZIRA VISHA L RA JESHKUMA R, he re by de clare that all state m e nts m ade in this application are true , com ple te and corre ct to the be st of m y k nowle dge and be lie f and in the e ve nt of any of the inform ation be ing found false or incorre ct or any ine ligibility be ing de te cte d be fore or afte r the te st m y candidature is liable to be cance lle d and action initiate d against m e . I have subm itte d only one application for this te st. I furthe r de clare that I fulfill all conditions of e ligibility re garding Age lim its, Educational qualifications e tc. pre scribe d for the te st. I also de clare that I have ne ve r be e n convicte d by any court of law. I de clare that I have gone through the conditions attache d to NET and shall abide by the sam e . I have e nclose d the atte ste d copie s of ce rtificate of be ing SC /ST/O BC /PH/VH (Physically or Visually handicappe d), (strik e which is not applicable ). I unde rstand that m y application will be re je cte d sum m arily if found incom ple te /ine ligible , and no corre sponde nce will be e nte rtaine d by C SIR in this re gard. Date : Place : Signature of the C andidate . A TTESTA TION(For 'RA ' Category Only) I ce rtify that the inform ation give n by the candidate Shri/Sm t/Kum SA NZIRA VISHA L RA JESHKUMA R has be e n ve rifie d by m e with re fe re nce to re cords. Also this is ce rtifiie d that the candidate is e nrolle d for M.Sc. or having com ple te d 10+2+3 ye ars of (BS-4 ye ar/BE/B.Te ch./B.Pharm a/MBBS/Inte grate d BS-MS or e quivale nt de gre e & is e ligible to appe ar unde r 'R A" cate gory as laid down in the e ligibility crite ria of C SIR -UGC NET De ce m be r 2012. (Strik e which is not applicable )

Signature of the He ad of De pt./Institute R ubbe r stam p/se al Nam e : De signation: NO TE : (Atte station should be signe d by the He ad of the De pt. or Institution whe re the candidate has appe are d O R will be appe aring in the above notifie d Q ualification/De gre e Ex am iniation as applicable ). 25. C hallan De tail. Nam e of the Bank Branch C ode Am ount in Figure (R s.) C hallan Date

: INDIA N BA NK : 1477 : 400 : 13/09/2012

Branch/C ity Journal No. Am ount in W ord(R s.) Phone

:DA XINI SOC/A HMEDA BA D : J/2118770 : FOUR HUNDRED : 09510962467

Signature of Applicant Note :Ple ase se nd hard copy of this O NLINE subm itte d application form duly signe d with re ce nt passport size Black & white photograph along with a copy of original challan (fe e de posit re ce ipt) m e ant for C SIR (Ex am ination Unit) with re quire d ce rtificate (s) by U.P.C ./ordinary Post only, as notifie d in the Em ploym e nt Ne ws/W e bsite by arranging your own e nve lop (5 X11 ) supe rscribing your subje ct code , application no., and ce ntre code which should re ach to the Sr. C ontrolle r of Ex am ination, Ex am ination Unit, Hum an R e source De ve lopm e nt Group, C SIR C om ple x , Library Ave nue , Pusa, Ne w De lhi-110012 on or be fore 24.09.2012 (01.10.2012 for re m ote are as). Please do not staple the hard copy of the A pplication form & enclosures.

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CSIR-UGC JRF/NET E am

Cut and Paste following address on your own envelop(5 X11 )

(Application for Joint CSIR-UGC Test for JRF/LS (NET), December, 2012) [6 - ENG | 02 - BHA | 02-ENGLISH]

To, Sr. Controller of Examinations Examination Unit, Human Resource Development Group CSIR Complex,opposite Institute of Hotel Management, Library Avenue Pusa, New Delhi-110012
0

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