National Centre for Cell Science, Pune

NATIONAL CENTRE FOR CELL SCIENCE, PUNE (An autonomous Institution of the Department of Biotechnology, Government of India) NCCS Complex, Pune University Campus, Ganeshkhind, Pune - 411007, Maharashtra, India.

APPLICATION FOR THE POSITION OF…………………. Note: - FILL UP ALL DETAILS IN BLOCK LETTERS. (Incomplete form will not be entertained)

01. Name (write your surname first, then 06.I) name)Permanent *Telephone/MobileAffix 02. NameAddress: of Father/Spouse Numbers:passport 03. Advt. No. & Post Code No. size State, City & Area 04. Date of Birth photograph Pin Code Number 05. Age as on (12/13.08.2014) 06.II) Correspondence Address: State, City & Area Pin Code Number 06.III) *E-mail Address: *Please make sure that the e-mail ID & mobile number is correct and legible.

07. Gender: 08. Marital status:

09. Nationality: 10. Whether SC/ST/OBC/

11. Additional Qualifying Examination(s) passed (A) CSIR/UGC- NET/LS (B) GATE Registration/Roll No.: Registration/Roll No.: Date of exam: Date of exam: Valid till: Valid till: Year of Passing: Year of Passing:

12. Educational Qualification: (Starting from SSC onwards) Degree/ Name of the Subjects/Speci Total Marks Percenta Month & Year Examination Board/University alization Obtained ge / of passing passed Grade

13. Experience: (Starting from the present/immediate last employer) Period Scale of Pay & Name & Address of Reasons for Post Held Gross Nature of Job the Employer Leaving Emoluments From To

14. Title of the Ph. D. thesis:

15. Research Publications with full references (if any):

16. Mailing information: Duly filled prescribed application form should sent us by email to [email protected] (Mention in the subject line “Application for the post of Research Associate or Post-Doctoral Fellow or Senior Research Fellow or Junior Research Fellow or Project Assistant”)

17. I am herewith submitting my post preferences:

Posts Post Sr. No. Post Sr. No. Post Sr. No. Post Sr. No. Post Sr. No. 1st 2nd 3rd 4th 5th Preference Preference Preference Preference Preference RA/PDF (Strike out whichever is not applicable) SRF (Strike out whichever is not applicable) JRF/PA (Strike out whichever is not applicable)

RS-Research Scientist/RA-Research Associate / PDF-Post-Doctoral Fellow / SRF-Senior Research Fellow / JRF-Junior Research Fellow / PA-Project Assistant/ AA-Admin Assistant/RA-Research Assistant/PF-Project Fellow

DECLARATION

I hereby declare that I have carefully read the instructions and particulars supplied to me and that the entries made in this application form are correct to the best of my knowledge and belief.

Date: - Signature of the Candidate