CSIR-CENTRE FOR CELLULAR AND MOLECULAR BIOLOGY

Uppal Road, Habsiguda, Hyderabad-500 007, TELANGANA

APPLICATION FORM

Advt. No. 01/2023 Particulars of Fee Paid:

Post Applied for: JS-01 - Jr.
Stenographer
Applying for category: UR
Amount of Fee Paid: Rs. 100
Transaction ID/Ref. No.:
DUM1412023
Transaction Date: 19-01-2024

Application No: 1233439

1. Name in full (BLOCK LETTERS) : Mr YASHWARDHAN SINGH PARIHAR

2. Father's/Husband's Name : Manoj Singh parihar

3. Date, Place of birth and Age a)Date: 09-01-2002 b)Place: Bikaner, Rajasthan
c) Age (as on 20-01-2024): 22 years 0 Months 11 Days

4. Gender : Male

5. Marital Status : Single

6. Address a) Correspondence: b) Permanent:

Street number 6 , Nagar Nigam ke Street number 6 , Nagar Nigam ke samne
samne hanuman Hatha hanuman Hatha
City: Bikaner City: Bikaner
State: Rajasthan State: Rajasthan
Pincode: 334001 Pincode: 334001

E Mail:yashuuu5@gmail.com

Tel. /Mob. No.:7410871750

7. Nationality : Indian

8. Name of State/UT to which you : Rajasthan

belong?

9. Religion : Hindu

10. State whether you belongs to : General

SC/ST/OBC/EWS. If so, attach an
attested copy of the certificate in
support of your claim

11. Are you a person with disability? If : No

yes, indicate type of disability and
percentage of disability

12. Are you an Ex-serviceman? If yes, : No

peirod of service rendered in Defense
Service (in years)

13. Are you a Government Servant at : No

present working in CSIR or Any Govt.
or PSU or Autonomous Organization?

14. Are you claiming for age : No NA

relaxation?

15. Are you related to any of the : No

employee of CSIR/CSIR-CCMB?
NOTE: Any change of address/ email / mobile No. in Col. 6 above, should be communicated immediately to recruitment@ccmb.res.in.
CSIR-CCMB, Hyderabad, will make every effort to take note of changes but cannot accept any responsibility in this matter.

16. Essential Educational Qualifications in chronological order

Examination or Degree or Name of the Percentage Year of

Subjects Class or Division
Diploma Board/University of Marks passing
Secondary all subjects CBSE first 81.7 2017
Sr. Secondary Physics, chemistry, Maths CBSE first 71.8 2019

17. Preferable language for proficiency test in Stenography: Hindi

18. Experience gained after obtaining the Essential Qualification:

Designation of the post, Name of the organization Type of Nature of Date of joining Date of leaving
salary & grade Organization employment
-NA-

19. Whether any prosecution/detention/fine/conviction/sentence against you : No

has been awarded by any court

20. Are you under any bond/contractual obligation to serve Central/State Govt./ : No
Public Sector

21. List of enclosures:

S.No Enclosure details Please tick
1. SSC/10th Certificate & Mark sheet (reflecting Date of Birth)

2. Intermediate/10+2/Diploma Certificate & Mark sheet

3. Graduation Certificate & Mark sheet
4. Caste/Category Certificate (wherever applicable) in the prescribed Government India format signed by
specific authority
5. Experience Certificate(s)
6. No Objection Certificate with vigilance clearance (wherever applicable)
7. Certificate(s) related to higher qualification, if any

8. Certificate related to PwBD (wherever applicable) in the prescribed format

Declaration

I YASHWARDHAN SINGH PARIHAR hereby declare that, all the information provided in this application form are true, complete and
correct to the best of my knowledge and belief, and in the event of any of the information being found false or incorrect or any
ineligibility being detected before or after the proficiency test / written examination, my candidature is liable to be cancelled and
action may be initiated against me.

Place: Bikaner
Date: 19-01-2024 Candidate's Signature