8/11/2014 CSIR-UGC JRF/NET Exam

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(14D)
Online Application Form
Joint CSIR-UGC Test for JRF and Eligibility For Lectureship, NET - 21-12-2014
[Council of Scientific & Industrial Research - HRD Group, Examination Unit]
1. RollNo(To be filled by Office Only) 2. Application No.
14D746850
3. Applied For : 02 - LECTURERSHIP
4. Subject : 1 - CHE - CHEMICAL SCIENCES
5. Exam Centre : 17 - LUC - LUCKNOW
6. Meduim of NET Exam(As applicable) : 01-HINDI

7. Candidate Name : PRAVEEN KUMAR
8. Sex : MALE
9. Father/Mother/Husband Name : FATHER -> RAM SEVAK
10. Date Of Birth : 15-08-1984
11. Age As On 01-07-2014 : 29 Y, 10 M, 17 D
12. Category : OBC
13. Physically/Visually Handicape(PH/VH) : NA
14. If VH, Do You Want Scribe's Help : NA

15. Write your name and complete Mailing Address.
Name: PRAVEEN KUMAR
Address: YADAV COLONY
INDRA NAGAR
MOHAMMADABAD
City: FARRUKHABAD
Pin: 209651
State: UTTAR PRADESH
Signature of Candidate ------>

16. Permanent Address
Name : PRAVEEN KUMAR
Address
: YADAV COLONY
INDRA NAGAR
MOHAMMADABAD City : FARRUKHABAD Pin : 209651 State : UTTAR PRADESH
17. Email : praveenyadav0123@gmail.com

Note:Bachelors degree holders will not be eligible for Lectureship]
18. Qualifying Degree : M.SC.
[Candidates enrolled for M.Sc. or having completed 10+2+3 years of qualifying examination as given in column
18, may apply under Result Awaited (RA) category]
19. If Result Awaited : NO
20. Year Of Appearing in Final Exam : NA (If Result Awaited)
21. Give detail of Final Exam Result (If not Result Awaited)
(a) Year Of Passing : 2010 (b) Division : FIRST (c) Mark Obtained (%) : 62 %
22. If enrolled in MS-PhD program : NO
(a) Year of enrollment : NA
(b) Year of passing bachelor degree : NA
(c) Division/Grade : NA
(d) Marks Obtained (%) : 0
8/11/2014 CSIR-UGC JRF/NET Exam
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Application No: 14D746850
23. Specialization :
(a) Specialization Code : 104 (b) Specialization Subject Name : PHYSICAL CHEMISTRY
24(a) University/Institute Code : 060
(b) University/Institute Name : DR. BHIM RAO AMBEDKAR UNIVERSITY, AGRA

DECLARATION
I, PRAVEEN KUMAR, hereby declare that all statements made in this application 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 test my candidature is liable to be cancelled and action
initiated
against me.
I have submitted only one application for this test.
I further declare that I fulfill all conditions of eligibility regarding Age limits, Educational qualifications etc.
prescribed for
the test.
I also declare that I have never been convicted by any court of law.
I declare that I have gone through the conditions attached to NET and shall abide by the same.
I have enclosed the attested copies of certificate of being SC/ST/OBC/PH/VH (Physically or Visually handicapped),
(strike which is not applicable).
I understand that my application will be rejected summarily if found incomplete/ineligible, and no correspondence
will be entertained by CSIR in this regard.
Date:
Place:
Signature of the Candidate.

ATTESTATION(For 'RA' Category Only)
Not Applicable For You as You have entered RESULT AWAITED as "NO"

25. Challan Detail.
Name of the Bank : INDIAN BANK Branch/City :AGRA
Branch Code : 106320 Journal No. : FGD4566
Amount in Figure(Rs.) : 200 Amount in Word(Rs.) : TWO HUNDRED
Challan Date : 05/08/2014 Phone : 9758064786

Signature of Applicant
Note:Please send hard copy of this ONLINE submitted application form duly signed with recent passport size Black &
white photograph along with a copy of original challan (fee deposit receipt) meant for CSIR(Examination Unit) with
required certificate(s) by U.P.C./ordinary Post only, as notified in the Employment News/Website by arranging your
own envelop (5X11) superscribing your subject code, application no., and centre code which should reach to the
Sr. Controller of Examination, Examination Unit, Human Resource Development Group, CSIR Complex, Library
Avenue, Pusa, New Delhi-110012 on or before 19-08-2014 (25-08-2014 for remote areas).
Please do not staple the hard copy of the Application form & enclosures.
8/11/2014 CSIR-UGC JRF/NET Exam
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(Application for Joint CSIR-UGC Test for JRF/LS (NET), December, 2014)
[1 - CHE | 14D746850 | 17 - LUC | 01-HINDI]
To,
Sr. Controller of Examinations
Examination Unit, Human Resource Development Group
CSIR Complex,opposite Institute of Hotel Management, Library Avenue
Pusa, New Delhi-110012
Cut and Paste following address on your own envelop(5X11)