NOTE:  

Your application has been successfully submitted.   Your Payment is successful. Dear
Candidate, please note that you will get a time window from date 12th Nov. 9.00 AM till 14th Nov. 11.59
PM to make correction in certain parts of the Application Form. However no changes are permitted in
the basic details which were provided during the Registration part.

Personal Details
Application Seq No :

GS2022CHMIPH005819

Full Name of the Applicant :

ANISHA MISHRA

Application Status : Date of Birth :

PaymentSuccess 07/Jan/2001

Other Personal Information

Nationality : Place of Birth :
Indian Bhubaneshwar

Marital Status : 10th Standard Roll No :

Not Married 6114860

10th Standard Year of Passing : 10th Standard Board :

2017 CBSE

Gender :

Female

Are you applying under the disabled category

recognised by Government of India:

No

Mobile Number : Email ID :

9556518015 anishamishra037@gmail.com

Present Address

Address Line 1:

PLOT NO-903 , BUDHESWARI OLD POST OFFICE LANE

 Address Line 2:

NEAR RASHMI VIHAR APPARTMENT

District/City : State/U.T. :

KHURDA ODISHA
Pincode :

751006

Subject / Program Details

Subject : Program:

Chemistry Int. Ph.D.

Degree Details
Latest Degree : Branch:
B.Sc. CHEMISTRY

College / Institution: Completed / Completing :

BIRLA INSTITUTE OF TECHNOLOGY Completing

Month and Year : In case of my selection for admission to the TIFR
Graduate School, I hereby undertake to provide my
May 2022
degree/passing certificate at the time of joining TIFR in
August 2022:

Accepted

I would like to apply for the programme in TIFR, Mumbai and the following
Centres/Programmes
TIFR Mumbai : TCIS Hyderabad :

Yes Yes

Appeared for the TIFR written test (for Ph.D./Int. Ph.D.

programmes) earlier/previously :

No

Applied for any post (other than Research Scholar) in

TIFR :

No

Ever participated in the VSRP programme in TIFR :

No

Exam City Preference

Preference 1 : Preference 2 :

Bhubaneshwar Delhi

Preference 3 :

Hyderabad
Payment Details
Payment Mode : Payment Amount :

Debit Card 600

Payment Status : Payment Transaction No.

Payment Successful 110314146930

Candidate Documents/Images Upload Details

Photo Signature

Declaration

I hereby, declare that the information provided above, is true and correct to the best of my
knowledge. I understand that to falsify information is grounds for refusing me the examination
Hall Ticket.

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