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Application Form CSIR

Some application form

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Joyee Basu
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44 views7 pages

Application Form CSIR

Some application form

Uploaded by

Joyee Basu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 7

- --

-- -, , - - 110001
COUNCIL OF SCIENTIFIC & INDUSTRIAL RESEARCH
ANUSANDHAN BHAWAN, RAFI MARG, NEW DELHI 110 001

- - -
FORM OF APPLICATION FOR APPOINTMENT BY SELECTION

Affix recent
signed
passport size
photograph

--

To be filled in by the candidate in his own


handwriting. All the columns should be properly
filled in. Incomplete application form will be
rejected summarily

- .............................................

- :

Advt.No. ___________________________

Particulars of application fee:

- ..........................................

.. . .....................................

Post applied for _____________________

D.D. No. & Date ____________________

( ) ...................................

- ..................................

Post Code (if any)___________________

Name of the Bank & Branch___________

1. - ( ) ..................................................................................
( - -
'' '' )
Name in full (In BLOCK LETTERS)
(In the case of female candidates, the appropriate
prefix `Miss or `Mrs should be used)

2. / -

..................................................................................

Fathers/Husbands Name

Contd.2/-

-2-

3. - -

().......................................................................

Date and place of birth

(a) Date:

()-:......................................................................
(b) Place:...
4. :
Address:

()
a) Correspondence: _____________________________________
_____________________________________
______________________________________

-:

Telephone No.__________E-mail:__________

:
Fax No._______________

()

(b)Permanent __________________________________________
__________________________________________
__________________________________________

5. - - ?

...........................................

Are you a citizen of India by birth or by domicile?

6. - -

______________

................................................

Name of State to which you belong

7. - /- -/-
? , - -
- - -
State whether you are a member of Scheduled Caste/
Scheduled Tribe/Other Backward Class. If so, attach
an attested copy of the certificate in support of your claim
(Tick the appropriate Category)

( -- )

______________
SC
ST
OBC
GEN
PH

-38.

?.................................................
,
.................................................
Are you related to any employees of the
CSIR? If so, give details.

9. / :
Educational professional Qualifications:

Exam
passed

/ /


Year
of Duration

Division/
Grade
and
% age of
marks

passing

Subject(s)

of Board/Univ.
the
Degree/
Diploma

Contd.4/-

-4-

10. ( ) :
Details of employment (in chronological order):-

-
Organization

-- -
Post
Exact dates to
held
given

be


( )

Total
_________________
period
Scale of

years)
pay &
From
To
last pay
drawn


Nature
duties
(in

11.

-- -- - .................................................
- ? - - .................................................
-- - -- - .................................................
Are you willing to accept the minimum initial pay
of the scale? If not, state, what is the lowest initial
pay that you would accept in the prescribed pay scale.

12.

...........................................................
, -
............................................................
Any additional qualification such as membership
of professional societies; awards and honours etc.,

13.

(- - )
(for S&T Posts)

() - - -
a) No. of Publications published in scientific journals

) -
b) No. of patents filed and granted

of

-5-

14.

- :
List of enclosures:

DECLARATION

.................................................... -
- - , -
- -

I ______________ hereby declare that the statements made in the 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 selection, my candidature is liable to be cancelled and action initiated against
me.

- :
Place:

Date:

Candidates signature
(

Full Name
________________________________________________________________________

- - - -- -

Candidate already employed should get the following endorsement signed by his/her
present employer.

/ - -
Endorsement by the Head of the Department or Office.

.
No.

- _______________
Date _______________
Full Signature _________________

__________________
- __________________

Designation _________________

Stamp


Synopsis Sheet

( - )
(Candidate should give complete information)

-
Name
of
Candidate

the

- - +
( Qualifications +
)

-/
-, -*

**

DOB & age as on


cut off date

Position Held and

From

to

Duration**

Experience

Honours/Awards
Publications, Patents*

-
-
Name of
Organisation
(1)

(2)

(3)

(4)

+ ../.. ,
+ Indicate the level of qualifications viz. B.Tech./M.Tech. etc., Division and % age of marks and year of passing.

** ,
** Mention specifically in number of years, months & days.

* - -
* for S&T posts.

(5)

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