S N BOSE NATIONAL CENTRE FOR BASIC SCIENCES
MIDTERM ADMISSION 2011
APPLICATION FOR POST M.SC. Ph.D. PROGRAMME
Your Application Number is:
dated:
(For Office Use only)
1. Have you qualified in
1. a. JEST
Month:
Year:
Registration Number:
All India Bank:
Score:
Percentile:
1.b. DBT-JRF
Month:
Year:
Registration Number:
1. c. NET-JRF
Month:
Year:
Registration Number:
2.
1.d. NET_LS
Month:
Year:
Registration Number:
Name exactly as appearing in the degree certificate:
3. a. Address for correspondence:
3. b. Pin code:
4. a. Contact Telephone:
Country Code:
STD
Phone Number:
4. b. Mobile-1:
4.c. Alternate Mobile-2:
5. a. Permanent Address:
5. b. Pin code:
6. a. E-mail:
6.b. Alternate E-mail:
7. Mother’s Name:
8. Father’s Name:
9. Date of Birth:
(yyyy-mm-dd)
Paste your recent Passport
Photo with Signature
10. Gender:
11. Caste:
12. DETAILS OF EDUCATIONAL QUALIFICATIONS:
EDUCATION
Degree
Year
Division
Grade
Percentage
(%)
Rank
Name of
Board /
University
STANDARD
10
STANDARD
12
Graduation
Post Graduation
Others
13. Highest Degree / Examination:
13. a. Whether Passed / Appearing / Appeared:
13. b. Present Institution:
13. c. Present University:
13. d. Specialisation / Branch:
13. e. Expected degree:
13. f. Percentage:
13. g. CGPA:
Out of:
13. h. Percentage of marks:
Completed up to:
Completed up to:
14. Choice of Department:
1 Department of Chemical, Biological & Macro-Molecular Sciences
2. Department of Condensed Matter Physics & Material Sciences
3. Department of Theoretical Sciences
4. Department of Astrophysics and Cosmology
15. Whether qualified INSPIRE-SHE, if yes, select Level:
16. Any other national level exam (Please specify Details)
Name of
Institution
17. Please write below (within 300 words) why you want to pursue a research career in the
area of your choice?
I do hereby declare that the information furnished above are all true to my knowledge and
believe. In case there is any deviation noted, I myself shall be held responsible.
Date:
-----------------------------------Signature of the Applicant