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Online Application FormJoint 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.

14J6829393. Applied For : 01 - JRF4. Subject : 5 - PHY - PHYSICAL SCIENCES5. Exam Centre : 05 - CHA - CHANDIGARH6. Meduim of NET Exam(As applicable) : 02-ENGLISH

7. Candidate Name : ANKUR8. Sex : MALE9. Father/Mother/Husband Name : FATHER -> KARAMVIR10. Date Of Birth : 22-10-199211. Age As On 01-01-2014 : 21 Y, 2 M, 9 D12. Category : OBC13. Physically/Visually Handicape(PH/VH) : NA14. If VH, Do You Want Scribe's Help : NA

15. Write your name and complete Mailing Address.Name: ANKURAddress: WARD NO.-7 HOUSE NO.- 110

NEAR BALMIKI MANDIRINDRI

City: KARNALPin: 132041

State: HARYANASignature of Candidate ------>

16. Permanent Address Name : ANKUR

Address: WARD NO.-7 HOUSE NO.- 110NEAR BALMIKI MANDIRINDRI City : KARNAL Pin : 132041 State : HARYANA

17. Email : [email protected]

18. Qualifying Degree : M.SC.[Candidates enrolled for M.Sc. or having completed 10+2+3 years of qualifying examination as given in column18, may apply under Result Awaited (RA) category]19. If Result Awaited : RA20. 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

CSIR-UGC JRF/NET Exam http://115.112.95.106/jrf/online/submit_form.jsp

1 of 3 Tuesday 25 February 2014 11:46 AM

Application No: 14J68293923. Specialization :(a) Specialization Code : 503 (b) Specialization Subject Name : CONDENSED MATTER PHYSICS24(a) University/Institute Code : 127(b) University/Institute Name : KURUKSHETRA UNIVERSITY, KURUKSHETRA

DECLARATIONI, ANKUR, hereby declare that all statements made in this application are true, complete andcorrect to the best of my knowledge and belief and in the event of any of the information being found false or incorrector any ineligibility being detected before or after the test my candidature is liable to be cancelled and action initiatedagainst 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 forthe 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), (strikewhich is not applicable).I understand that my application will be rejected summarily if found incomplete/ineligible, and no correspondence will beentertained 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 torecords.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 theeligibility criteria of CSIR-UGC NET June 2014. (Strike which is not applicable)

Signature of the Head of Dept./InstituteRubber stamp/seal

Name:Designation:

NOTE : (Attestation should be signed by the Head of the Dept. or Institution where the candidate has appeared OR will beappearing in the above notied Qualication/Degree Examiniation as applicable).

25. Challan Detail.Name of the Bank : INDIAN BANK Branch/City :KURUKSHETRABranch Code : 2040 Journal No. : 834459Amount in Figure(Rs.) : 200 Amount in Word(Rs.) : TWO HUNDREDChallan Date : 24/02/2014 Phone : 9467416267

Signature of ApplicantNote:Please send hard copy of this ONLINE submitted application form duly signed with recent passport size Black & whitephotograph along with a copy of original challan (fee deposit receipt) meant for CSIR(Examination Unit) with requiredcerticate(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 ofExamination, Examination Unit, Human Resource Development Group, CSIR Complex, Library Avenue, Pusa, New Delhi-110012 on or before 08-03-2014 (14-03-2014 for remote areas).Please do not staple the hard copy of the Application form & enclosures.



(Application for Joint CSIR-UGC Test for JRF/LS (NET), June, 2014)[5 - PHY | 14J682939 | 05 - CHA | 02-ENGLISH]

To,Sr. Controller of ExaminationsExamination Unit, Human Resource Development GroupCSIR Complex,opposite Institute of Hotel Management, Library AvenuePusa, New Delhi-110012

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



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