8/7/2014

CSIR-UGC JRF/NET Exam

You must check your registration status when it is notified on our website csirhrdg.res.in
(14D)

Online Application Form

Joint CSIR-UGC Test for JRF and Eligibility For Lectureship, NET - 21-12-2014
[Council of Scientific & Industrial Research - HRD Group, Examination Unit]
1. RollNo(To be filled by Office Only)

2. Application No.

14D699798
3. Applied For

: 01 - JRF

4. Subject

: 6 - ENG - ENGINEERING SCIENCES

5. Exam Centre

: 08 - DEL - DELHI

6. Meduim of NET Exam(As applicable)

: 02-ENGLISH

7. Candidate Name

: GAUTAM KUNAL

8. Sex

: MALE

9. Father/Mother/Husband Name

: FATHER -> ASHOK KUMAR VARMA

10. Date Of Birth

: 25-12-1988

11. Age As On 01-07-2014

: 25 Y, 6 M, 6 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:

GAUTAM KUNAL

Address:

C/O SHISHMANI KUMARI STAFF NURSE

R H S COMPLEX DENDUA
PO SALANPUR

City:

BURDWAN

Pin:

713357

State:

WEST BENGAL
Signature of Candidate ------>

16. Permanent Address

Name

: GAUTAM KUNAL

Address

: C/O ASHOK KUMAR VERMA

HNO 40 VILL INDAUT PO BHAWANBARUI
HILSA
City : NALANDA Pin : 801302
State : BIHAR

17. Email

: gautamkunalworld@gmail.com

Note:Bachelors degree holders will not be eligible for Lectureship]

18. Qualifying Degree

: B.TECH.

[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

: NO

20. Year Of Appearing in Final Exam

: NA

(If Result Awaited)

21. Give detail of Final Exam Result (If not Result Awaited)
(a) Year Of Passing : 2013

(b) Division : FIRST

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

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

(c) Mark Obtained (%) : 73.50 %

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CSIR-UGC JRF/NET Exam

Application No:

14D699798

23. Specialization :
(a) Specialization Code : 605
ENGINEERING

(b) Specialization Subject Name : ELECTRONICS AND COMMUNICATION

24(a) University/Institute Code

: 165

(b) University/Institute Name

: NATIONAL INSTITUTE OF TECHNOLOGY

DECLARATION
I, GAUTAM KUNAL, 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 fulfill all conditions of eligibility regarding Age limits, Educational qualifications 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 certificate 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)

Not Applicable For You as You have entered RESULT AWAITED as "NO"
25. Challan Detail.
Name of the Bank
Branch Code
Amount in Figure(Rs.)
Challan Date

:
:
:
:

INDIAN BANK
1908
200
07/08/2014

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

:MALVIYA NAGAR DELHI

: 900485
: TWO HUNDRED
: 8447320663

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
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 Sr. Controller of
Examination, Examination Unit, Human Resource Development Group, CSIR Complex, Library Avenue, Pusa, New Delhi-110012
on or before 19-08-2014 (25-08-2014 for remote areas).
Please do not staple the hard copy of the Application form & enclosures.

http://59.163.216.82:8080/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), December, 2014)
[6 - ENG | 14D699798 | 08 - DEL | 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://59.163.216.82:8080/jrf/online/submit_form.jsp

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