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(14J)

CSIR-UGC JRF/NET Exam

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Online Application Form Joint CSIR-UGC Test for JRF and Eligibility For Lectureship, NET - 22-06-2014 [Council of Scientific & Industrial Research - HRD Group, Examination Unit]
1. R ollNo(To be fille d by O ffice O nly) 2. Application No.

14J819926
3. Applie d For 4. Subje ct 5. Ex am C e ntre 6. Me duim of NET Ex am (As applicable ) 7. C andidate Nam e 8. Se x 9. Fathe r/Mothe r/Husband Nam e 10. Date O f Birth 11. Age As O n 01-01-2014 12. C ate gory 13. Physically/Visually Handicape (PH/VH) 14. If VH, Do You W ant Scribe 's He lp : 01 - JRF : 6 - ENG - ENGINEERING SCIENCES : 03 - BHO - BHOPA L : 02-ENGLISH : HITESH KUMA R SA DA NI : MA LE : FA THER -> M K SA DA NI : 05-03-1993 : 20 Y, 9 M, 24 D : GEN : NA : NA

15. W rite your nam e and com ple te Mailing Addre ss. Nam e : Addre ss : HITESH KUMA R SA DA NI 88 BA LA JI NA GA R J K ROA D NA RELA SHA NKA RI BHOPA L BHOPA L 462021 MA DHYA PRA DESH Signature of C andidate ------>

C ity: Pin : State :

16. Pe rm ane nt Addre ss Nam e Addre ss 17. Em ail : HITESH KUMA R SA DA NI : 88 BA LA JI NA GA R J K ROA D NA RELA SHA NKA RI BHOPA L C ity : BHOPA L Pin : 462021 State : MA DHYA PRA DESH : hitesh.sadani5@gmail.com

18. Q ualifying De gre e

: B.E.

[Candidates enrolled for M.Sc. or having completed 10+2+3 years of qualifying examination as given in column 18, may apply under Result A waited (RA ) category] 19. If R e sult Awaite d 20. Ye ar O f Appe aring in Final Ex am (a) Ye ar O f Passing : NA 22. If e nrolle d in MS-PhD program (a) Ye ar of e nrollm e nt (b) Ye ar of passing bache lor de gre e (c) Division/Grade (d) Mark s O btaine d (%) : RA : 2014 (If R e sult Awaite d) (c) Mark O btaine d (%) : 0 %

21. Give de tail of Final Ex am R e sult (If not R e sult Awaite d) (b) Division : NA : NO : NA : NA : NA :0

http://115.112.95.106/jrf/online/submit_form.jsp

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CSIR-UGC JRF/NET Exam

Application No: 23. Spe cialization : (a) Spe cialization C ode : 608 24(a) Unive rsity/Institute C ode (b) Unive rsity/Institute Nam e (b) Spe cialization Subje ct Nam e : MECHA NICA L ENGINEERING : 999 : RA JIV GA NDHI PROUDYOGIKI VISHWA VIDHYA LA YA , BHOPA L 14J819926

DECLA RA TION I, HITESH KUMA R SA DA NI , he re by de clare that all state m e nts m ade in this application are true , com ple te and corre ct to the be st of m y k nowle dge and be lie f and in the e ve nt of any of the inform ation be ing found false or incorre ct or any ine ligibility be ing de te cte d be fore or afte r the te st m y candidature is liable to be cance lle d and action initiate d against m e . I have subm itte d only one application for this te st. I furthe r de clare that I fulfill all conditions of e ligibility re garding Age lim its, Educational qualifications e tc. pre scribe d for the te st. I also de clare that I have ne ve r be e n convicte d by any court of law. I de clare that I have gone through the conditions attache d to NET and shall abide by the sam e . I have e nclose d the atte ste d copie s of ce rtificate of be ing SC /ST/O BC /PH/VH (Physically or Visually handicappe d), (strik e which is not applicable ). I unde rstand that m y application will be re je cte d sum m arily if found incom ple te /ine ligible , and no corre sponde nce will be e nte rtaine d by C SIR in this re gard. Date : Place : Signature of the C andidate . A TTESTA TION(For 'RA ' Category Only) I ce rtify that the inform ation give n by the candidate Shri/Sm t/Kum HITESH KUMA R SA DA NI has be e n ve rifie d by m e with re fe re nce to re cords. Also this is ce rtifiie d that the candidate is e nrolle d for M.Sc. or having com ple te d 10+2+3 ye ars of (BS-4 ye ar/BE/B.Te ch./B.Pharm a/MBBS/Inte grate d BS-MS or e quivale nt de gre e & is e ligible to appe ar unde r 'R A" cate gory as laid down in the e ligibility crite ria of C SIR -UGC NET June 2014. (Strik e which is not applicable )

Signature of the He ad of De pt./Institute R ubbe r stam p/se al Nam e : De signation: NO TE : (Atte station should be signe d by the He ad of the De pt. or Institution whe re the candidate has appe are d O R will be appe aring in the above notifie d Q ualification/De gre e Ex am iniation as applicable ). 25. C hallan De tail. Nam e of the Bank Branch C ode Am ount in Figure (R s.) C hallan Date

: INDIA N BA NK : 00530 : 400 : 04/03/2014

Branch/C ity Journal No. Am ount in W ord(R s.) Phone

:M P NA GA R, BHOPA L : 3017072 : FOUR HUNDRED : 09752335925

Signature of Applicant Note :Ple ase se nd hard copy of this O NLINE subm itte d application form duly signe d with re ce nt passport size Black & white photograph along with a copy of original challan (fe e de posit re ce ipt) m e ant for C SIR (Ex am ination Unit) with re quire d ce rtificate (s) by U.P.C ./ordinary Post only, as notifie d in the Em ploym e nt Ne ws/W e bsite by arranging your own e nve lop (5X11) supe rscribing your subje ct code , application no., and ce ntre code which should re ach to the Sr. C ontrolle r of Ex am ination, Ex am ination Unit, Hum an R e source De ve lopm e nt Group, C SIR C om ple x , Library Ave nue , Pusa, Ne w De lhi-110012 on or be fore 19-03-2014 (25-03-2014 for re m ote are as). Please do not staple the hard copy of the A pplication form & enclosures.

http://115.112.95.106/jrf/online/submit_form.jsp

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CSIR-UGC JRF/NET Exam

Cut and Paste following address on your own envelop(5X11)

(Application for Joint CSIR-UGC Test for JRF/LS (NET), June, 2014) [6 - ENG | 14J819926 | 03 - BHO | 02-ENGLISH]

To, Sr. Controller of Examinations Examination Unit, Human Resource Development Group CSIR Complex,opposite Institute of Hotel Management, Library Avenue Pusa, New Delhi-110012

http://115.112.95.106/jrf/online/submit_form.jsp

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