UGC - National Eligibility Test December, 2014

Print Copy of Application Form

(ONE COPY TO BE SUBMITTED TO THE COORDINATING INSTITUTION)

To be Filled by the Coordinating Institution only

The particulars furnished by the
candidate have been checked and
verified

Roll No.: 05081452

BANARAS HINDU UNIVERSITY, VARANASI 221

005.(05)
COORDINATING INSTITUTION
Subject Code

08

Coordinating Institution
Code

05

CO-ORDINATOR (Signature)

OFFICE SEAL
1. Applied for

: BOTH(JRF & ASSISTANT PROFESSOR)

2. Subject opted for NET

: COMMERCE

3. Name

: SONIA SARFARAZ

Photograph signed by the

candidate and duly

4. Date of Birth (as recorded in matriculation or : 24/08/1984

equivalent certificate)

attested by the Head of

Deptt. / Institution or

5. Gender

: FEMALE

6. Category

: GENERAL

7. Visually Challanged / Physically Challenged

: NO

8. Father's Name

: SARFARAZ AHMAD

9. Mother's Name

: KANIZ FATIMA

10. Examination Appearing/ Passed

: M.COM.

11. Name of the University/ Institution

VEER BAHADUR SINGH PURVANCHAL

: UNIVERSITY, JAUNPUR-222 002 (STATE
UNIVERSITY).

12. Marks/ Grade

: MARKS

Marks Obtained

: 542

Affix recent Passport size

Class-I Gazetted Officer

(DO NOT USE STAPLER
OR PIN)

Total Marks

: 900

% of Marks
Obtained

: 60.22

13. Fee Payment Details

Payment Mode : Debit/Credit Card
Exam Fee Amount (Rs.) : 450 /-

Transaction ID : ASMP3555667679
Date of Transaction : 14-11-2014 18:59:03

Card Type : VISA/Master Card

14. Phone No.

: NA

15. Email

: SURESHVARANASI2008@GMAIL.COM

Mobile No.

: 9919543393

Declaration
i) I, SONIA SARFARAZ hereby declare that all statements made in the online 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 entrtained in this regard. vi) I have read and agreed with the Notification for the UGC NET including instructions,
enclosures, check list and other relevant information.
Date: 11/14/2014 6:53:22 PM
Place:
Signature of Candidate