10/11/2018 CSIR-UGC NET Exam :: Candidate Application

(18D)
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Online Application Form

Joint CSIR-UGC Test for JRF & LS(NET), December, 2018
[Council of Scientific & Industrial Research - HRD Group, Examination Unit]
(Only Indian Nationals Can Apply)

Application No.
18D6175718 18D6175718

[A] JRF/NET Option Details

1. Apply for JRF or LS : 1 - JUNIOR RESEARCH

FELLOWSHIP(JRF)

2. Subject : 1 - CHE - CHEMICAL SCIENCES

3. Specialization:

(a) Specialization Code : 102

(b) Specialization Name : INORGANIC CHEMISTRY

4. Exam Centre : 18 - LUC - LUCKNOW

5. Medium of Exam(As applicable) : 02-ENGLISH

[B] Personal Details

[As mentioned in Matriculation Certificate]

1. Name of the Candidate : Ms. PRERNA NISHAD

2. Email Address : PRERNA31NISHAD@GMAIL.COM

3. Mobile Number : +91-8423497326

4. Phone : NA

5. Gender : FEMALE

6. Father's Name : LUXMI KANT NISHAD

7. Mother's Name : NAVITA DEVI

8. Husband's Name (in case of married : NA

female)

9. Date Of Birth : 01-02-1996

Age As On 01-07-2018 : 22 Y, 5 M, 0 D

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[OBC candidates whose caste is listed only in the State List and not listed in Central List are not eligible to
apply under OBC category and have to apply as General category candidates]

10. Category : OBC

[Caste should be listed in the central list, for which you may confirm from NCBC website i.e
www.ncbc.nic.in]

Name of State and Caste : UTTAR PRADESH - MALLAH

[For S.no. 11 and 12 below, only Persons with 40% or more disability(PwD) as per valid medical certificate
shall be considered]

11. Person with : NA

Disablity(PwD)?

12. If PwD, do you require scribe? : NA

[C] Name and complete Mailing Address [Please refer Information Bulletin]

1. Name : Ms. PRERNA NISHAD

2. Address : 270/201 A CHAUKHANDI KYDGANJ ALLAHABAD

3. City : ALLAHABAD 4. Pin : 211003 5. State : UTTAR PRADESH

[D] Permanent Address

1. Name : Ms. PRERNA NISHAD

2. Address : 270/201 A CHAUKHANDI KYDGANJ ALLAHABAD

3. City : ALLAHABAD 4. Pin : 211003 5. State : UTTAR PRADESH

[E] Qualifying Degree Details [Please refer Information Bulletin]

[Bachelor's degree holders will not be eligible for Lectureship, as per instructions contained in Information
Bulletin]

Qualifying Degree : M.SC.

[Candidates enrolled for M.Sc. or having completed 10+2+3 years of qualifying examination, may apply
under Result Awaited (RA) category]
In case the candidates are awarded grades/CGPA instead of marks, the conversion of grades/CGPA to
percentage/ marks would be based on the conversion formula certified by the university/institution from
where the candidate has obtained their degrees.

► Bachelor Degree Details

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1. Month & Year of Passing

: 06-2016

2. Percentage (%) : 47.11%

3. Obtained Marks : 848

4. Maximum Marks : 1800

► Qualifying Degree Details

1. Month & Year of Enrollment : 08-2017

2. Duration In Year : 2.0

3. University/Institute : HEMAWTI NANDAN BAHUGUNA RAJKIYA

DEGREE COLLEGE NAINI ALLAHABAD

4. If Result Awaited (RA) : YES

► 2nd Semester / 1st Year Details

1. Month & Year of Passing : 06-2018

2. Percentage (%) : 52.4%

3. Obtained Marks : 262

4. Maximum Marks : 500

► Final Semester / Final Year Details

1. Month & Year of Enrollment : 09-2018

2. Likely Year of Passing in Final : 2019

Semester/Final Year

[F] Uploaded Documents

► Qualifying final/last Marksheet : ✔

► Caste Certificate : ✔
► Attested Certificate [if RA (Yes)] : ✔

[G] Fee Details

1. Amount in Figure(Rs.) : 500.00

2. Amount in Word : RUPEES FIVE HUNDRED ONLY

3. Fee Status : SUCCESS

4. Reference No. : PUR26781412962

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5. Payment Date : 2018-10-11 22:56:54

[H] DECLARATION

I, Ms. PRERNA NISHAD, a citizen of India have read and understood the instructions
contained in the Information Bulletin and 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 further declare that I fulfil 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 uploaded self attested copies of certificate of being SC/ST/OBC/PwD (Persons with
Disabilities)/Qualifying Degree MarkSheet(As 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: 2018-10-11
22:56:54

Signature of Applicant

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