CSIR-UGC JRF/NET Exam

1 of 3

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

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(14J)

Online Application Form

Joint CSIR-UGC Test for JRF and Eligibility For Lectureship, NET - 22-06-2014
[Council of Scientic & Industrial Research - HRD Group, Examination Unit]
1. RollNo(To be lled by Oce Only)

2. Application No.

14J682939
3. Applied For

: 01 - JRF

4. Subject

: 5 - PHY - PHYSICAL SCIENCES

5. Exam Centre

: 05 - CHA - CHANDIGARH

6. Meduim of NET Exam(As applicable)

: 02-ENGLISH

7. Candidate Name

: ANKUR

8. Sex

: MALE

9. Father/Mother/Husband Name

: FATHER -> KARAMVIR

10. Date Of Birth

: 22-10-1992

11. Age As On 01-01-2014

: 21 Y, 2 M, 9 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:

ANKUR

Address:

WARD NO.-7 HOUSE NO.- 110

NEAR BALMIKI MANDIR
INDRI

City:

KARNAL

Pin:

132041

State:

HARYANA
Signature of Candidate ------>

16. Permanent Address

Name

: ANKUR

Address

: WARD NO.-7 HOUSE NO.- 110

NEAR BALMIKI MANDIR
INDRI
City : KARNAL Pin : 132041

17. Email

: bargotraboy@gmail.com

18. Qualifying Degree

State : HARYANA

: 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

: RA

20. Year Of Appearing in Final Exam

: 2014

(If Result Awaited)

21. Give detail of Final Exam Result (If not Result Awaited)
(a) Year Of Passing : NA

(b) Division : NA

(c) Mark Obtained (%) : 0 %

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

Tuesday 25 February 2014 11:46 AM

CSIR-UGC JRF/NET Exam

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

Application No:

14J682939

23. Specialization :
(a) Specialization Code : 503

(b) Specialization Subject Name : CONDENSED MATTER PHYSICS

24(a) University/Institute Code

: 127

(b) University/Institute Name

: KURUKSHETRA UNIVERSITY, KURUKSHETRA

DECLARATION
I, ANKUR, 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 fulll all conditions of eligibility regarding Age limits, Educational qualications 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 certicate 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)
I certify that the information given by the candidate Shri/Smt/Kum ANKUR has been veried by me with reference to
records.
Also this is certiied that the candidate is enrolled for M.Sc. or having completed 10+2+3 years of (BS-4 year/BE/B.Tech.
/B.Pharma/MBBS/Integrated BS-MS or equivalent degree & is eligible to appear under 'RA" category as laid down in the
eligibility criteria of CSIR-UGC NET June 2014. (Strike which is not applicable)

Signature of the Head of Dept./Institute

Rubber stamp/seal
Name:
Designation:
NOTE : (Attestation should be signed by the Head of the Dept. or Institution where the candidate has appeared OR will be
appearing in the above notied Qualication/Degree Examiniation as applicable).
25. Challan Detail.
Name of the Bank
Branch Code
Amount in Figure(Rs.)
Challan Date

: INDIAN BANK
: 2040
: 200
: 24/02/2014

Branch/City
Journal No.
Amount in Word(Rs.)
Phone

:KURUKSHETRA
: 834459
: TWO HUNDRED
: 9467416267

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
certicate(s) by U.P.C./ordinary Post only, as notied 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 Delhi110012 on or before 08-03-2014 (14-03-2014 for remote areas).
Please do not staple the hard copy of the Application form & enclosures.

Tuesday 25 February 2014 11:46 AM

CSIR-UGC JRF/NET Exam

3 of 3

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

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

(Application for Joint CSIR-UGC Test for JRF/LS (NET), June, 2014)
[5 - PHY | 14J682939 | 05 - CHA | 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

Tuesday 25 February 2014 11:46 AM