sasor7 CSIR-UGC JRFINET Exam ATMA 373695692 Ps ae a. Father/Mother/Husbane Name LATHER > PRADIP NIKHAR 30, Date OF Birth 7-08-1994 3, age As On 01-01-2017 :22Y, 4M, 25D [OBC category candidates not belonging to OBC (Non Creamy Layer) and whose caste isnot lst [shall indicate thelr category as General. See para 2.2 and para 5.1 of main notification] 32. category BC [For s.no. 13 and 14 only Persons with 40% and above disability(PwD) as per valid medical certificate shall \considered} 23. Parson with Dsablty(PwO)? :¢.1F Pwd, Do you want senbe's help In Contrattist 35. write your name and complete Naling Adress Do not Staple Name NIKHAR VAIBHAV PRADIP Paste a Recent Accressi—- BHANAPETH WARD ‘& White Photograph PATELHIGH SCHOOL x citys ‘CHANDRAPUR Fin 442401 Bearing signature ot 5 MAHARASHTRA Candidate Signature of Candidate ~ :BHANAPETH WARD khar@gmallcom Note:Bachelor’s degre ble for Lectureship} 18. Qualifying Degree B.TECH holders willnot be [candidates enrolled for M.Sc. or having completed 10+24+3 years of qualifying examination as given in column | may apply under Resut Awaited (WA) category] 19. If Result Avatted NO 20, Yeo OF Appearing in Final Exam NA. (IF Result Awsites) 21, Give deal of Final Exam Result (If not Result Avated) (2) Year OF Passing 2016 (2) Division : FIRST CLASS () Mark Ostaines (3) +70 4% (2) Year of enrliment NA (6) Yeer of passing bechelor degree ENA (©) Marks Obtained (%) 10 nip89 16.216 8:8080)totinetsubmitforms0susot7 CSIR-UGC JRFINET Exam Appliation No: a73easee2 22, Spadalzation| (2) Specialization Code: 105 (©) Specialization Subject Name # O1LS, OLEOCHEMICALS AND SURFACTANTS 24{a) Universitynsitute Code 999 (0) Universty/Institate Name INSTITUTE OF CHEMICAL TECHNOLOGY, MUMBA hi, NIKHAR VAIBHAV PRADIP, hereby declore that all statements made inthis application are tr, complete and [correct to tha best of my knowleoge and delet and nthe event of any ofthe information beng Found falze or incorect orang inaiiblity being detected defore or after te test my cancidatire is lable fo be canceled ara action mitted have submitted only one application for this test. further ectare that 1 fri al canations of eligibility regarding Age limits, Educational qualifications ete, presribed far the test Ht Gectare that Ihave gone trough the conditions attached to NET and shal abide by the same. hve ences he aeses cols of ceete of being SC/ST/OSC/PH/ (Pnystal or Vuatyhancapped) (sie [uncerstara that my application will be rejected summarily if found Incomplete/ineligble, and ne comesponcence will be lentertined by CSIR mn this regrd Date Pace Sianature ofthe Candiéate "ATTESTATION(For RA Cal Not Applicable For You as You have entered RESULT AWAITED as "NO 35, Challon Detar Neme ofthe Banie INDIAN BANK Braneycity PUNE Branch Code 324 Journal No, 2356386 Jamount in Figures.) +500 ‘amount in Word(s.) FIVE HUNDRED Jcratian Date (02/03/2017 Prone 8308842705 Signature of Applicat Note: Please sona hard copy of ths ONLINE submitted application form dul laned with recent porsport size Block & whi frosograph along with a copy oF orignal challan (Fee deposit recat) meant for CSIR{Examination Unt) with required Eenineata(s) by UPC /ordnary Post ony, as natiied in the Employment Newa/Weste by arranging your awn snveloy ks-x:1") superserbing your subject code,’ application ro., and centre code which should reach to the Deputy. Secretary Kexams), examination Unt, Human Resource Development Graup, CSIR Complex, Library Avenue, Pusa, New Delh-1L0012 o br betore 14-03-2017 (1-09-2017 for emote areas). please do not staple the hard copy of the Application form & enclosures. Inoter s*e+s** Na changes inthe application form wil be allowed after submission‘***= ps9 169.216 2:8080)etortinetsubmit forms 28sasor7 CSIR-UGC JRFINET Exam Cut and Paste following address on your own envelop(5"K11") (Application for Joint CSIR-UGC Test for JRF & LS(NET), June, 2017) [1 - CHE | 173695692 | 01 - BAN | 02-ENGLISH] 'To, {Deputy Secretary (Exams) i | Examination Unit, Human Resource Development Group : {CSIR Complex,opposite Institute of Hotel Management, Library Avenue Pusa, New Delhi-110012 nip89 16.216 8:8080)totinetsubmitforms0 a8