You are on page 1of 16

Print

UGC - NATIONAL ELIGIBILITY TEST FOR JUNIOR RESEARCH FELLOWSHIP


AND ELIGIBILITY FOR LECTURESHIP JUNE, 2012
ADMISSION CARD (PROVISIONAL)
(TO BE SUBMITTED TO THE TEST CENTRE)

Guru Govind Singh Indraprastha University, Sector-16 C,


Test Centre:
Dwarka, New Delhi-110075(17)
Venue of Test: Roll No. 17061518
(To be filled by the Test
Centre only)

Subject: History Code: 06


Name of the Candidate: Mr. HEMANT KUMAR VERMA
Father's Name: Shri. P.D. VERMA
Mother's Name: Smt. BHAGWATI DEVI
C/O MR. P. K. ANSHUMAN ( ASSISTANT PROFESSOR )
Address for
KIRORI MAL COLLEGE , DELHI UNIVERSITY , DELHI
Correspondence:
110007, DELHI, DELHI, DELHI, INDIA
Pin: 110007
Affix recent Passport size
Date of Test : Sunday; Jun. 24, 2012 Photograph signed by the
candidate and duly
Timings attested by the Head of
Paper-I, Paper-II : 9:30 A.M. - 10:45 A.M., 10:45 A.M. - 12:00 Noon the Deptt./Institution or
Class I Gazetted Officer
Paper-III : 01:30 P.M. - 04:00 P.M.
(DO NOT USE STAPLER
NOTE (1) No TA will be paid for appearing in the Test OR PIN)
(2) Entry to the Examination Hall will not be allowed without this card.
(3) Cellular phone/Mobile/Pager/Calculator /Log Tables etc. shall not be allowed in the
Examination Hall/Room.

SIGNATURE OF CO-ORDINATOR ________________ Signature of Candidate _____________________


Print

UGC - NATIONAL ELIGIBILITY TEST FOR JUNIOR RESEARCH FELLOWSHIP


AND ELIGIBILITY FOR LECTURESHIP JUNE, 2012
ADMISSION CARD (PROVISIONAL)
(TO BE SUBMITTED TO THE TEST CENTRE)

Guru Govind Singh Indraprastha University, Sector-16 C,


Test Centre:
Dwarka, New Delhi-110075(17)
Venue of Test: Roll No. 17061518
(To be filled by the Test
Centre only)

Subject: History Code: 06


Name of the Candidate: Mr. HEMANT KUMAR VERMA
Father's Name: Shri. P.D. VERMA
Mother's Name: Smt. BHAGWATI DEVI
C/O MR. P. K. ANSHUMAN ( ASSISTANT PROFESSOR )
Address for
KIRORI MAL COLLEGE , DELHI UNIVERSITY , DELHI
Correspondence:
110007, DELHI, DELHI, DELHI, INDIA
Pin: 110007
Affix recent Passport size
Date of Test : Sunday; Jun. 24, 2012 Photograph signed by the
candidate and duly
Timings attested by the Head of
Paper-I, Paper-II : 9:30 A.M. - 10:45 A.M., 10:45 A.M. - 12:00 Noon the Deptt./Institution or
Class I Gazetted Officer
Paper-III : 01:30 P.M. - 04:00 P.M.
(DO NOT USE STAPLER
NOTE (1) No TA will be paid for appearing in the Test OR PIN)
(2) Entry to the Examination Hall will not be allowed without this card.
(3) Cellular phone/Mobile/Pager/Calculator /Log Tables etc. shall not be allowed in the
Examination Hall/Room.

SIGNATURE OF CO-ORDINATOR ________________ Signature of Candidate _____________________


Print

UGC - NATIONAL ELIGIBILITY TEST JUNE, 2012


ATTENDANCE SLIP FOR USE AT THE TEST CENTRE
(TO BE SUBMITTED TO THE TEST CENTRE FOR USE ON THE DAY OF EXAMINATION)
(DATE OF TEST :Sunday; Jun. 24, 2012)

Roll No. 17061518

NAME: Mr. HEMANT KUMAR VERMA


SUBJECT: History SUBJECT CODE: 06

* SIGNATURE OF CANDIDATE
PAPER TIMING
(IN EXAMINATION HALL)

PAPER-I 9:30 A.M. TO 10:45 A.M.


Affix recent Passport size
PAPER-II 10:45 A.M. TO 12:00 Noon Photograph signed by the
candidate and duly
PAPER-III 01:30 P.M. TO 4:00 P.M. attested by the Head of
the Deptt./Institution or
Class I Gazetted Officer

(DO NOT USE STAPLER


OR PIN)

SIGNATURE OF CO-ORDINATOR ________________ Signature of Candidate _____________________


NOTE: This attendance slip should be retained by the Co-ordinator and must be given to the Invigilator for verification with Roll
Number issued to the candidate.
* The signature of the candidate should be taken on the day of examination.
Print

UGC - NATIONAL ELIGIBILITY TEST JUNE, 2012


ATTENDANCE SLIP FOR USE AT THE TEST CENTRE
(TO BE SUBMITTED TO THE TEST CENTRE FOR USE ON THE DAY OF EXAMINATION)
(DATE OF TEST :Sunday; Jun. 24, 2012)

Roll No. 17061518

NAME: Mr. HEMANT KUMAR VERMA


SUBJECT: History SUBJECT CODE: 06

* SIGNATURE OF CANDIDATE
PAPER TIMING
(IN EXAMINATION HALL)

PAPER-I 9:30 A.M. TO 10:45 A.M.


Affix recent Passport size
PAPER-II 10:45 A.M. TO 12:00 Noon Photograph signed by the
candidate and duly
PAPER-III 01:30 P.M. TO 4:00 P.M. attested by the Head of
the Deptt./Institution or
Class I Gazetted Officer

(DO NOT USE STAPLER


OR PIN)

SIGNATURE OF CO-ORDINATOR ________________ Signature of Candidate _____________________


NOTE: This attendance slip should be retained by the Co-ordinator and must be given to the Invigilator for verification with Roll
Number issued to the candidate.
* The signature of the candidate should be taken on the day of examination.
Print

UGC - NATIONAL ELIGIBILITY TEST JUNE, 2012


Print Copy of Application Form
(TO BE SUBMITTED TO THE TEST CENTRE IN DUPLICATE)

To be Filled by the Test Centre only


The particulars furnished by the
Roll No. 17061518 candidate have been checked and
verified

Guru Govind Singh Indraprastha University,


Sector-16 C, Dwarka, New Delhi-110075(17) __________________________
UNIVERSITY TEST CENTRE CO-ORDINATOR (Signature)

Affix recent Passport size


Photograph signed by the
Subject Code 06 candidate and duly
Centre Code 17 attested by the Head of
__________________________ the Deptt./Institution or
Class I Gazetted Officer
OFFICE SEAL

NET Examination Detail (DO NOT USE STAPLER


OR PIN)
1. Applied for : JRF and Lectureship Both
2. (i) Post Graduation
: Passed
Examination
2. (ii) Subject of Post-
: History
Graduation
3. Subject opted for NET : History
4. Centre of Examination : Guru Govind Singh Indraprastha University,
Sector-16 C, Dwarka, New Delhi-110075(17)

Personal Information
5. Name (as per Hr. Sec.
: Mr. HEMANT KUMAR VERMA
Matriculation Certificate
6. Date of Birth (as recorded
: 13-07-1980
in matriculation or
equivalent certificate)
7. Sex : MALE

Whether relaxation in age [Under Category:


: Yes
is sought SC/ST/OBC/PH/VH/Women ]

8. Category : SC
9. Visually Handicapped
(V/H) / Physically : Not Applicable
Handicapped (PH)
10.
Father's Name : Shri P.D. VERMA
(i)
10.
Mother's Name : Smt. BHAGWATI DEVI
(ii)
11. Address for : C/O MR. P. K. ANSHUMAN ( ASSISTANT
Communication PROFESSOR ) KIRORI MAL COLLEGE ,
DELHI UNIVERSITY , DELHI
110007,DELHI, DELHI, DELHI, INDIA,
110007
12. Permanent Address : S/O SHRI P.D. VERMA (EX. DEPUTY
POSTMASTER ) H.N. 101 , MOH.
NAIBASTI KATRA , POST GURSARAI
DISTT. JHANSI U.P. 284202,GURSARAI,
GURSARAI, U.P., INDIA, 284202

Detail of Educational Qualification


13. (a) Examination Appearing/Passed : MA
13. (b) Name of the University : BUNDELKHAND UNIVERSITY JHANSI (Uttar Pradesh)
13. (c) Year of Passing : 2004
13. (d) Subject Offered : HISTORY
13. (e) RESEARCH SCHOLAR IN DEPARTMENT OF HISTORY OF
Specialization ( if any ) :
ARTS
13. (f) Marks/Grade : Marks
Mark Obtained : 542
Total Marks : 900
% of marks obtained : 60.22%
Passed M. Phil: No Passed Ph. D.: No

14. Detail of Fee Deposited


Name of the Bank : STATE BANK OF INDIA
Name of the Branch : Sbi Lanka Varanasi
Branch Code : 11508
Journal No. : 17303177
Deposit Date : 25-04-2012
Amount : Rs. 110

The State/UT which you


15. : Uttar Pradesh(25)
belong

Phone No. (with STD


Place: Varanasi 0518260858
Code)
Date: 25-04-2012 Mobile No.: 9936580092
Email: hemantkumarverma97@gmail.com

Declaration
i) I, HEMANT KUMAR VERMA, 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________________
Print

UGC - NATIONAL ELIGIBILITY TEST JUNE, 2012


Print Copy of Application Form
(TO BE SUBMITTED TO THE TEST CENTRE IN DUPLICATE)

To be Filled by the Test Centre only


The particulars furnished by the
Roll No. 17061518 candidate have been checked and
verified

Guru Govind Singh Indraprastha University, Sector-16 C,


Dwarka, New Delhi-110075(17) __________________________
UNIVERSITY TEST CENTRE CO-ORDINATOR (Signature)

Subject Code 06
Centre Code 17 Affix recent Passport size
__________________________ Photograph signed by the
OFFICE SEAL candidate and duly
attested by the Head of
NET Examination Detail the Deptt./Institution or
Class I Gazetted Officer
1. Applied for : JRF and Lectureship Both

2. (i) Post Graduation Examination : Passed (DO NOT USE STAPLER


OR PIN)
2. (ii) Subject of Post-Graduation : History

3. Subject opted for NET : History

4. Centre of Examination : Guru Govind Singh Indraprastha University, Sector-16


C, Dwarka, New Delhi-110075(17)

Personal Information
5. Name (as per Hr. Sec.
: Mr. HEMANT KUMAR VERMA
Matriculation Certificate

6. Date of Birth (as recorded in


matriculation or equivalent : 13-07-1980
certificate)

7. Sex : MALE

Whether relaxation in age is [Under Category: SC/ST/OBC/PH/VH/Women


: Yes
sought ]

8. Category : SC
9. Visually Handicapped (V/H) /
: Not Applicable
Physically Handicapped (PH)

10.
Father's Name : Shri P.D. VERMA
(i)

10.
Mother's Name : Smt. BHAGWATI DEVI
(ii)

11. Address for Communication : C/O MR. P. K. ANSHUMAN ( ASSISTANT


PROFESSOR ) KIRORI MAL COLLEGE , DELHI
UNIVERSITY , DELHI 110007,DELHI, DELHI, DELHI,
INDIA, 110007

12. Permanent Address : S/O SHRI P.D. VERMA (EX. DEPUTY POSTMASTER
) H.N. 101 , MOH. NAIBASTI KATRA , POST
GURSARAI DISTT. JHANSI U.P. 284202,GURSARAI,
GURSARAI, U.P., INDIA, 284202

Detail of Educational Qualification


13. (a) Examination Appearing/Passed : MA
13. (b) Name of the University : BUNDELKHAND UNIVERSITY JHANSI (Uttar Pradesh)

13. (c) Year of Passing : 2004

13. (d) Subject Offered : HISTORY

13. (e) Specialization ( if any ) : RESEARCH SCHOLAR IN DEPARTMENT OF HISTORY OF ARTS

13. (f) Marks/Grade : Marks

Mark Obtained : 542


Total Marks : 900
% of marks obtained : 60.22%

Passed M. Phil: No Passed Ph. D.: No

14. Detail of Fee Deposited


Name of the Bank : STATE BANK OF INDIA

Name of the Branch : Sbi Lanka Varanasi

Branch Code : 11508

Journal No. : 17303177

Deposit Date : 25-04-2012

Amount : Rs. 110


15. The State/UT which you belong : Uttar Pradesh(25)

Phone No. (with STD


Place: Varanasi 0518260858
Code)
Date: 25-04-2012 Mobile No.: 9936580092
Email: hemantkumarverma97@gmail.com

Declaration
i) I, HEMANT KUMAR VERMA, 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________________
Print

UGC - NATIONAL ELIGIBILITY TEST JUNE, 2012


Print Copy of Application Form
(TO BE SUBMITTED TO THE TEST CENTRE IN DUPLICATE)

To be Filled by the Test Centre only


The particulars furnished by the
Roll No. 17061518 candidate have been checked and
verified

Guru Govind Singh Indraprastha University,


Sector-16 C, Dwarka, New Delhi-110075(17) __________________________
UNIVERSITY TEST CENTRE CO-ORDINATOR (Signature)

Affix recent Passport size


Photograph signed by the
Subject Code 06 candidate and duly
Centre Code 17 attested by the Head of
__________________________ the Deptt./Institution or
Class I Gazetted Officer
OFFICE SEAL

NET Examination Detail (DO NOT USE STAPLER


OR PIN)
1. Applied for : JRF and Lectureship Both
2. (i) Post Graduation
: Passed
Examination
2. (ii) Subject of Post-
: History
Graduation
3. Subject opted for NET : History
4. Centre of Examination : Guru Govind Singh Indraprastha University,
Sector-16 C, Dwarka, New Delhi-110075(17)

Personal Information
5. Name (as per Hr. Sec.
: Mr. HEMANT KUMAR VERMA
Matriculation Certificate
6. Date of Birth (as recorded : 13-07-1980
in matriculation or
equivalent certificate)
7. Sex : MALE

Whether relaxation in age [Under Category:


: Yes
is sought SC/ST/OBC/PH/VH/Women ]

8. Category : SC
9. Visually Handicapped
(V/H) / Physically : Not Applicable
Handicapped (PH)
10.
Father's Name : Shri P.D. VERMA
(i)
10.
Mother's Name : Smt. BHAGWATI DEVI
(ii)
11. Address for : C/O MR. P. K. ANSHUMAN ( ASSISTANT
Communication PROFESSOR ) KIRORI MAL COLLEGE ,
DELHI UNIVERSITY , DELHI
110007,DELHI, DELHI, DELHI, INDIA,
110007
12. Permanent Address : S/O SHRI P.D. VERMA (EX. DEPUTY
POSTMASTER ) H.N. 101 , MOH.
NAIBASTI KATRA , POST GURSARAI
DISTT. JHANSI U.P. 284202,GURSARAI,
GURSARAI, U.P., INDIA, 284202

Detail of Educational Qualification


13. (a) Examination Appearing/Passed : MA
13. (b) Name of the University : BUNDELKHAND UNIVERSITY JHANSI (Uttar Pradesh)
13. (c) Year of Passing : 2004
13. (d) Subject Offered : HISTORY
13. (e) RESEARCH SCHOLAR IN DEPARTMENT OF HISTORY OF
Specialization ( if any ) :
ARTS
13. (f) Marks/Grade : Marks
Mark Obtained : 542
Total Marks : 900
% of marks obtained : 60.22%
Passed M. Phil: No Passed Ph. D.: No

14. Detail of Fee Deposited


Name of the Bank : STATE BANK OF INDIA
Name of the Branch : Sbi Lanka Varanasi
Branch Code : 11508
Journal No. : 17303177
Deposit Date : 25-04-2012
Amount : Rs. 110

The State/UT which you


15. : Uttar Pradesh(25)
belong

Phone No. (with STD


Place: Varanasi 0518260858
Code)
Date: 25-04-2012 Mobile No.: 9936580092
Email: hemantkumarverma97@gmail.com

Declaration
i) I, HEMANT KUMAR VERMA, 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________________
Print

UGC - NATIONAL ELIGIBILITY TEST JUNE, 2012


Print Copy of Application Form
(TO BE SUBMITTED TO THE TEST CENTRE IN DUPLICATE)

To be Filled by the Test Centre only


The particulars furnished by the
Roll No. 17061518 candidate have been checked and
verified

Guru Govind Singh Indraprastha University, Sector-16 C,


Dwarka, New Delhi-110075(17) __________________________
UNIVERSITY TEST CENTRE CO-ORDINATOR (Signature)

Subject Code 06
Centre Code 17 Affix recent Passport size
__________________________ Photograph signed by the
OFFICE SEAL candidate and duly
attested by the Head of
NET Examination Detail the Deptt./Institution or
Class I Gazetted Officer
1. Applied for : JRF and Lectureship Both

2. (i) Post Graduation Examination : Passed (DO NOT USE STAPLER


OR PIN)
2. (ii) Subject of Post-Graduation : History

3. Subject opted for NET : History

4. Centre of Examination : Guru Govind Singh Indraprastha University, Sector-16


C, Dwarka, New Delhi-110075(17)

Personal Information
5. Name (as per Hr. Sec.
: Mr. HEMANT KUMAR VERMA
Matriculation Certificate

6. Date of Birth (as recorded in


matriculation or equivalent : 13-07-1980
certificate)

7. Sex : MALE

Whether relaxation in age is [Under Category: SC/ST/OBC/PH/VH/Women


: Yes
sought ]

8. Category : SC
9. Visually Handicapped (V/H) /
: Not Applicable
Physically Handicapped (PH)

10.
Father's Name : Shri P.D. VERMA
(i)

10.
Mother's Name : Smt. BHAGWATI DEVI
(ii)

11. Address for Communication : C/O MR. P. K. ANSHUMAN ( ASSISTANT


PROFESSOR ) KIRORI MAL COLLEGE , DELHI
UNIVERSITY , DELHI 110007,DELHI, DELHI, DELHI,
INDIA, 110007

12. Permanent Address : S/O SHRI P.D. VERMA (EX. DEPUTY POSTMASTER
) H.N. 101 , MOH. NAIBASTI KATRA , POST
GURSARAI DISTT. JHANSI U.P. 284202,GURSARAI,
GURSARAI, U.P., INDIA, 284202

Detail of Educational Qualification


13. (a) Examination Appearing/Passed : MA
13. (b) Name of the University : BUNDELKHAND UNIVERSITY JHANSI (Uttar Pradesh)

13. (c) Year of Passing : 2004

13. (d) Subject Offered : HISTORY

13. (e) Specialization ( if any ) : RESEARCH SCHOLAR IN DEPARTMENT OF HISTORY OF ARTS

13. (f) Marks/Grade : Marks

Mark Obtained : 542


Total Marks : 900
% of marks obtained : 60.22%

Passed M. Phil: No Passed Ph. D.: No

14. Detail of Fee Deposited


Name of the Bank : STATE BANK OF INDIA

Name of the Branch : Sbi Lanka Varanasi

Branch Code : 11508

Journal No. : 17303177

Deposit Date : 25-04-2012

Amount : Rs. 110


15. The State/UT which you belong : Uttar Pradesh(25)

Phone No. (with STD


Place: Varanasi 0518260858
Code)
Date: 25-04-2012 Mobile No.: 9936580092
Email: hemantkumarverma97@gmail.com

Declaration
i) I, HEMANT KUMAR VERMA, 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________________

You might also like