25/02/2016

CSIRUGCJRF/NETExam
Youmustcheckyourregistrationstatuswhenitisnotifiedonourwebsitecsirhrdg.res.in

(16J)

OnlineApplicationForm
JointCSIRUGCTestforJRF&LS(NET),June,2016
[CouncilofScientific&IndustrialResearchHRDGroup,ExaminationUnit]
1.RollNo(TobefilledbyOfficeOnly)

2.ApplicationNo.

16J686905
16J686905

3.AppliedFor

:01JRF

4.Subject

:5PHYPHYSICALSCIENCES

5.ExamCentre

:08DELDELHI

6.MeduimofNETExam(Asapplicable)

:02ENGLISH

7.CandidateName

:MONIKA

8.Sex

:FEMALE

9.Father/Mother/HusbandName

:FATHER>SUBASH

10.DateOfBirth

:09051992

11.AgeAsOn01012016

:23Y,7M,22D

12.Category

:GEN

13.Physically/VisuallyHandicape(PH/VH)

:NA

14.IfVH,DoYouWantScribe'sHelp

:NA

15.WriteyournameandcompleteMailingAddress.
Name:

MONIKA

Address:

VPODUMERKHAKALAN
DISTTJIND

City:

NARWANA

Pin:

126116

State:

HARYANA

SignatureofCandidate>

16.PermanentAddress
Name
Address
17.Email

:MONIKA
:VPODUMERKHAKALAN
DISTTJINDCity:NARWANAPin:126116State:HARYANA
:memonika00@gmail.com

Note:BachelorsdegreeholderswillnotbeeligibleforLectureship]
18.QualifyingDegree

:M.SC.

[CandidatesenrolledforM.Sc.orhavingcompleted10+2+3yearsofqualifyingexaminationasgivenincolumn
18,mayapplyunderResultAwaited(RA)category]
19.IfResultAwaited

:NO

20.YearOfAppearinginFinalExam

:NA(IfResultAwaited)

21.GivedetailofFinalExamResult(IfnotResultAwaited)
(a)YearOfPassing:2014(b)Division:1ST(c)MarkObtained(%):77.75%
22.IfenrolledinMSPhDprogram

:NO

(a)Yearofenrollment

:NA

(b)Yearofpassingbachelordegree

:NA

(c)Division/Grade

:NA

(d)MarksObtained(%)

:0

http://59.163.216.82:8080/jrf/online/submit_form.jsp

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CSIRUGCJRF/NETExam
ApplicationNo:

16J686905

23.Specialization:
(a)SpecializationCode:510(b)SpecializationSubjectName:PARTICLEPHYSICSANDMATERIALSCIENCE
24(a)University/InstituteCode

:127

(b)University/InstituteName

:KURUKSHETRAUNIVERSITY,KURUKSHETRA

DECLARATION
I,MONIKA,herebydeclarethatallstatementsmadeinthisapplicationaretrue,completeand
correcttothebestofmyknowledgeandbeliefandintheeventofanyoftheinformationbeingfoundfalseorincorrect
oranyineligibilitybeingdetectedbeforeorafterthetestmycandidatureisliabletobecancelledandactioninitiated
againstme.
Ihavesubmittedonlyoneapplicationforthistest.
IfurtherdeclarethatIfulfillallconditionsofeligibilityregardingAgelimits,Educationalqualificationsetc.prescribedfor
thetest.
IalsodeclarethatIhaveneverbeenconvictedbyanycourtoflaw.
IdeclarethatIhavegonethroughtheconditionsattachedtoNETandshallabidebythesame.
I have enclosed the attested copies of certificate of being SC/ST/OBC/PH/VH (Physically or Visually handicapped), (strike
whichisnotapplicable).
I understand that my application will be rejected summarily if found incomplete/ineligible, and no correspondence will be
entertainedbyCSIRinthisregard.
Date:
Place:
SignatureoftheCandidate.

ATTESTATION(For'RA'CategoryOnly)

NotApplicableForYouasYouhaveenteredRESULTAWAITEDas"NO"

25.ChallanDetail.
NameoftheBank
BranchCode
AmountinFigure(Rs.)
ChallanDate

:INDIANBAN
:1104
:1000
:24/02/2016

Branch/City
JournalNo.
AmountinWord(Rs.)
Phone

:HAUZKHAS
:607205
:ONETHOUSAND
:9896431308

SignatureofApplicant
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 Deputy Secretary
(Exams),ExaminationUnit,HumanResourceDevelopmentGroup,CSIRComplex,LibraryAvenue,Pusa,NewDelhi110012on
orbefore07032016(14032016forremoteareas).
PleasedonotstaplethehardcopyoftheApplicationform&enclosures.
Note:*******Nochangesintheapplicationformwillbeallowedaftersubmission*****

http://59.163.216.82:8080/jrf/online/submit_form.jsp

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25/02/2016

CSIRUGCJRF/NETExam

CutandPastefollowingaddressonyourownenvelop(5X11)

(ApplicationforJointCSIRUGCTestforJRF&LS(NET),June,2016)
[5PHY|16J686905|08DEL|02ENGLISH]

To,
DeputySecretary(Exams)
ExaminationUnit,HumanResourceDevelopmentGroup
CSIRComplex,oppositeInstituteofHotelManagement,LibraryAvenue
Pusa,NewDelhi110012

http://59.163.216.82:8080/jrf/online/submit_form.jsp

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