UGC - NET DECEMBER 2019

Confirmation Page

Application No. 1905 2021 9956 -

DO NOT SEND THIS PAGE TO NATIONAL TESTING AGENCY (NTA).
CANDIDATE IS REQUESTED TO RETAIN THE PRINTOUT OF CONFIRMATION PAGE FOR FUTURE REFERENCE.

Personal Details
Candidate's Name USHA R Date of Birth 05-05-1981
Mother's Name THANGAMMAL R Category OBC- NCL (Central List)
Father's Name RAMASAMY G Gender Female
Are you Single Girl Child in your family NO If you are a PwD Candidate, No
without brother or sister? do you have benchmark
disability (40% or more /
“Severe” where percentage is
not defined) ?
Nationality Indian Do you belong to Minority No
Community ?
Name of Minority Community Are You Diabetic? NO

Apply For
Apply For ASSISTANT PROFESSOR Subject Opted for NET Management (including Business Admn.
Mgt./Marketing/ Marketing Mgt./Industrial
Relations and Personnel Mgt./ Personnel
Mgt./Financial Mgt./Co-operative Management)
1st Choice for Exam City TAMIL NADU - VELLORE 2nd Choice for Exam City TAMIL NADU - KANCHIPURAM
3rd Choice for Exam City TAMIL NADU - SALEM 4th Choice for Exam City TAMIL NADU - TIRUVALLUR

Research/M.Phil/PhD/ExServiceman Details
Specialization, if Any
Whether you Poses Research Experience in the subject of PG Degree NO
Whether M.Phill Passed/Appearing NO
Whether Ph.D. Passed/Appearing NO
Whether you are an Ex-Serviceman ? NO

Contact Details
Address NARIYANERI VILLAGE, KANDHAILI Locality
City/Town/Village THIRPATTUR District VELLORE
State /UT TAMIL NADU Pin Code 635901
Email Address ush**************@gmail.com Mobile Number (+91) 994****154
Land Line No. with --
STD code or any
other Contact No.

Fee Payment Details

Payment Mode: Pay through PAYTM Transaction ID: 20190917111212800110168267988044
582
Exam Fee: 500 /- Date of Transaction: 17/09/2019 12:00:00
Fee Submitted On: 17/09/2019
DECLARATION
I hereby declare that all the particulars given by me in this form are true to the best of my knowledge and belief and any mistake / misinformation, detected at the time
of admission or at any stage in future, will result in the cancellation of admission/candidature. I have read the information bulletin and understood all the procedures. In
case I furnish any false information, my result will not be declared/ my candidature will automatically stand cancelled. I shall abide by terms and conditions therein.

Images Uploaded by Candidate

Photograph Signature

List of Document Uploaded

Photograph,Signature

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