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    Csir-Ugc JRF - Net Exam

    Uploaded by

    Pragyan Phukan
    The document is an online application form for Pragyan Phukan to take the CSIR-UGC JRF/NET exam in December 2015. It provides details such as his registration number, subject of physics, exam center in Guwahati, and personal information including name, date of birth, address, education details, and declaration of truthfulness.

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    © All Rights Reserved
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    Csir-Ugc JRF - Net Exam

    Uploaded by

    Pragyan Phukan
    93 views3 pages
    The document is an online application form for Pragyan Phukan to take the CSIR-UGC JRF/NET exam in December 2015. It provides details such as his registration number, subject of physics, exam center in Guwahati, and personal information including name, date of birth, address, education details, and declaration of truthfulness.

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    Csir-ugc Jrf_net Exam

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    The document is an online application form for Pragyan Phukan to take the CSIR-UGC JRF/NET exam in December 2015. It provides details such as his registration number, subject of physics, exam center in Guwahati, and personal information including name, date of birth, address, education details, and declaration of truthfulness.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    93 views3 pages

    Csir-Ugc JRF - Net Exam

    Uploaded by

    Pragyan Phukan
    The document is an online application form for Pragyan Phukan to take the CSIR-UGC JRF/NET exam in December 2015. It provides details such as his registration number, subject of physics, exam center in Guwahati, and personal information including name, date of birth, address, education details, and declaration of truthfulness.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 3

    8/18/2015

    CSIRUGCJRF/NETExam
    Youmustcheckyourregistrationstatuswhenitisnotifiedonourwebsitecsirhrdg.res.in

    (15D)

    OnlineApplicationForm
    JointCSIRUGCTestforJRF&LS(NET),December,2015
    [CouncilofScientific&IndustrialResearchHRDGroup,ExaminationUnit]
    1.RollNo(TobefilledbyOfficeOnly)

    2.ApplicationNo.

    15D647694
    15D647694

    3.AppliedFor

    :01JRF

    4.Subject

    :5PHYPHYSICALSCIENCES

    5.ExamCentre

    :10GUWGUWAHATI

    6.MeduimofNETExam(Asapplicable)

    :02ENGLISH

    7.CandidateName

    :PRAGYANPHUKAN

    8.Sex

    :MALE

    9.Father/Mother/HusbandName

    :FATHER>HEMCHANDRAPHUKAN

    10.DateOfBirth

    :01011994

    11.AgeAsOn01072015

    :21Y,6M,0D

    12.Category

    :OBC

    13.Physically/VisuallyHandicape(PH/VH)

    :NA

    14.IfVH,DoYouWantScribe'sHelp

    :NA

    15.WriteyournameandcompleteMailingAddress.
    Name:

    PRAGYANPHUKAN

    Address:

    KMH,TEZPURUNIVERSITY
    NAPAAM

    City:

    SONITPUR

    Pin:

    784028

    State:

    ASSAM

    SignatureofCandidate>

    16.PermanentAddress
    Name

    :PRAGYANPHUKAN

    Address

    :C/OHEMCHANDRAPHUKAN
    RATANPURGAON
    City:DHEMAJJIPin:787057State:ASSAM

    17.Email

    :phukan.pragyan@gmail.com

    Note:BachelorsdegreeholderswillnotbeeligibleforLectureship]
    18.QualifyingDegree

    :M.SC.

    [CandidatesenrolledforM.Sc.orhavingcompleted10+2+3yearsofqualifyingexamination as given in column


    18,mayapplyunderResultAwaited(RA)category]
    19.IfResultAwaited

    :RA

    20.YearOfAppearinginFinalExam

    :2016(IfResultAwaited)

    21.GivedetailofFinalExamResult(IfnotResultAwaited)
    (a)YearOfPassing:NA(b)Division:NA(c)MarkObtained(%):0%
    22.IfenrolledinMSPhDprogram

    :NO

    (a)Yearofenrollment

    :NA

    (b)Yearofpassingbachelordegree

    :NA

    (c)Division/Grade

    :NA

    (d)MarksObtained(%)

    :0

    file:///C:/Users/Pragyan/Desktop/CSIRUGC%20JRF_NET%20Exam.htm

    1/3

    8/18/2015

    CSIRUGCJRF/NETExam
    ApplicationNo:

    15D647694

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

    :229

    (b)University/InstituteName

    :TEZPURUNIVERSITY,TEZPUR

    DECLARATION
    I,PRAGYANPHUKAN,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)
    I certify that the information given by the candidate Shri/Smt/Kum PRAGYAN PHUKAN has been verified by me with
    referencetorecords.
    Also this is certifiied that the candidate is enrolled for M.Sc. or having completed 10+2+3 years of (BS4
    year/BE/B.Tech./B.Pharma/MBBS/Integrated BSMS or equivalent degree & is eligible to appear under 'RA" category as laid
    downintheeligibilitycriteriaofadb[0].getAdv_title().(Strikewhichisnotapplicable)

    SignatureoftheHeadofDept./Institute
    Rubberstamp/seal
    Name:

    Designation:
    NOTE : (Attestation should be signed by the Head of the Dept. or Institution where the candidate has appeared OR will be
    appearingintheabovenotifiedQualification/DegreeExaminiationasapplicable).

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

    :INDIANBANK
    :1514
    :500
    :17/08/2015

    Branch/City
    JournalNo.
    AmountinWord(Rs.)
    Phone

    :TEZPUR
    :4000914
    :FIVEHUNDRED
    :9613066737

    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
    orbefore03092015(10092015forremoteareas).
    PleasedonotstaplethehardcopyoftheApplicationform&enclosures.
    Note:*******Nochangesintheapplicationformwillbeallowedaftersubmission*****

    file:///C:/Users/Pragyan/Desktop/CSIRUGC%20JRF_NET%20Exam.htm

    2/3

    8/18/2015

    CSIRUGCJRF/NETExam

    CutandPastefollowingaddressonyourownenvelop(5X11)

    (ApplicationforJointCSIRUGCTestforJRF&LS(NET),December,2015)
    [5PHY|15D647694|10GUW|02ENGLISH]

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

    file:///C:/Users/Pragyan/Desktop/CSIRUGC%20JRF_NET%20Exam.htm

    3/3

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