07/03/2019 CSIR-UGC NET Exam :: Candidate Application

(19J)
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Online Application Form

Application No.
19J6079813
19J6079813

[A] JRF/NET Option Details

1. Apply for JRF or LS : 1 - JUNIOR RESEARCH FELLOWSHIP(JRF)

2. Subject : 5 - PHY - PHYSICAL SCIENCES

3. Specialization:

(a) Specialization Code : 508

(b) Specialization Name : QUANTUM PHYSICS

4. Exam Centre : 17 - KOL - KOLKATA

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

[B] Personal Details

[As mentioned in Matriculation Certificate]

1. Name of the Candidate : Mr. SOUMYADEEP MAITI

2. Email Address : [email protected]

3. Mobile Number : +91-7980618838

4. Phone : 7980618838

5. Gender : MALE

6. Father's Name : RABINDRANATH MAITI

7. Mother's Name : BANANI MAITI

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

9. Date Of Birth : 10-05-1997

Age As On 01-01-2019 : 21 Y, 7 M, 22 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 : GEN

[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 Disablity(PwD)? : NA

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

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

1. Name : Mr. SOUMYADEEP MAITI

2. Address : VILL-SOUTH KAMRANGU,P.O-JHOREHAT,P.S-SANKRAIL,ANDUL,HOWRAH

3. City : HOWRAH 4. Pin : 711302 5. State : WEST BENGAL

[D] Permanent Address

1. Name : Mr. SOUMYADEEP MAITI

2. Address : VILL-SOUTH KAMRANGU,P.O-JHOREHAT,P.S-SANKRAIL,ANDUL,HOWRAH

3. City : HOWRAH 4. Pin : 711302 5. State : WEST BENGAL

[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

1. Month & Year of Passing

: 06-2018

2. Percentage (%) : 51.38%

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3. Obtained Marks : 411

4. Maximum Marks : 800

► Qualifying Degree Details

1. Month & Year of Enrollment : 07-2018

2. Duration In Year : 2.0

3. University/Institute : VIDYASAGAR UNIVERSITY

4. If Result Awaited (RA) : YES

► Semester/Year Details

Optional : NA

► Final Semester / Final Year Details

1. Month & Year of Enrollment : 02-2020

2. Likely Year of Passing in Final : 2020

[F] Uploaded Documents

► Qualifying final/last Marksheet :✔

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

[G] Fee Details

1. Amount in Figure(Rs.) : 1000.00

2. Amount in Word : RUPEES ONE THOUSAND ONLY

3. Fee Status : SUCCESS

4. Reference No. : QUR27297134195

5. Payment Date : 2019-03-07 15:04:54

[H] DECLARATION

I, Mr. SOUMYADEEP MAITI, 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

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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.
I understand that mere submission of online application is not a criterion for selection.
Online application system is meant for capturing application data with maximum
possible validation rules to assist in filling up online application. It is my responsibility to
preview the application for correctness before final submission. At any stage of the
exam process, if it is found that I do not fulfill any of the laid down eligibility criteria, my
candidature will stand cancelled.

Date: 2019-03-07
15:04:54

Signature of Applicant

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