Application Form For Junior Research Fellowship/Research Associate in DMRL, Hyderabad. (To Be Filled by The Candidate in His/her Own Handwriting)

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Annexure-II

APPLICATION FORM FOR JUNIOR RESEARCH FELLOWSHIP/RESEARCH ASSOCIATE IN


DMRL, HYDERABAD.
(To be filled by the candidate in his/her own handwriting)

Name/Type of Fellowship....................................................................... Advertisement No..............................


1. Full Name in Block Letters: ANKIT GUPTA

2. (i) Father’s Name: ASHWANI GUPTA


(ii) Mother’s Name: ANITA GUPTA
(iii) Spouse Name(if applicable):
(in Block letters)

3. (a) Gender: Male/Female/Third Gender MALE (b) GEN SC ST OBC


(c) Date of Birth: DD/M/YYYY 08/01/1992 (d) Age 28 Yrs 10 Months

4. Correspondence Address: Pin code:

5. Permanent Address: Pin code:

6. Contact Details: Phone (with STD code): Mobile: +91


Alternate No, if any:

7. (i) E-mail ID:


(ii) Alternate E-mail ID:

8. Educational Qualification (From Matric/10th / HSC onwards, self-attested copies to be enclosed):

Examination Subject(s) Board/University Month &Year of Division/Class/ Percentage(%)/CGPA


Passed Passing Grade

9. Experience (if any) Note: Attach sheets (if required period of Service Job Description (in Brief)

Name of Name of the From To


Post/Designation Organization/Dept.

10. Whether Qualified UGC/CSIR/NET/GATE Examination Yes No

If yes, give details (Proof to be enclosed) Enrollment / Roll No..........Year...............Score.........Validity

11. Have you ever been debarred for recruitment examination by any Govt. Agency Yes No

If so give details:

12. Declaration: I hereby declare that, the above furnished particulars are correct to the best of myknowledge and
no information is suppressed. If at any time I am found to have concealed/distorted anyinformation, my
fellowship shall be liable to summarily terminated without any prior notice. I am ready, to takeup and
discharge the duties assigned to me anywhere in India, as end when required.

Place:

Date: Signature of the Candidate

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