8/12/2019 Appl Proforma

1/3

Inter University Accelerator Centre

(An Autonomous Research facility of University Grant Commission, New Delhi,

India)

Post o! No" #$%$&, Aruna Asaf Ali 'ar, New Delhi##$$*+

Application form

Advertisement No" $&&$#-

1. NA'. /0 12. P/31 APP4I.D 0/R :

2. Full Name (in Capital letters) :

3. Fathers Name :

4. Mothers Name :

5 us!an"s Name (#n case of female marrie"can"i"ates )

$. Nationalit%

&. (a) A""ress for communication ('ith inCo"e)

(!) ermanent A""ress

(c) *mail #+

(") Mo!ile phone No.

,. +ate of -irth (++MM////)

0. Ae as on the "ate of last "ate of receipt ofapplication

1.

Cateor% (C-C6N)(Certificate o!taine" from 7e8enue fficial not!elo9 the ran of +eput% ahsil"ar CompetentMe"ical Authorit% in case of shoul" !e attache"as e8i"ence)

##5

Details of .ducational 6ualifications (3tartin from class 7 onwards5 All columnsare to 8e filled u9)

;amasse"

#nstitution of mars

#&5 Details of Professional 1echnical .ducational 6ualifications Additional 3heet may 8eadded, if re:uired" (All columns are to 8e filled)

;amasse"

#nstitution

8/12/2019 Appl Proforma

2/3

*2*

13. +etails of ;perience (Can"i"ates are a"8ise" to fill*up this column carefull% an" in terms ofcon"itions stipulate" in the A"8ertisement to a8oi" re=ection) A""itional sheet ma% !e a""e"@ ifreuire".

Name of/rani;ation

Postheld

Pay 3cale Duration of 3ervice Nature ofa99ointment

whetherreular or

adhoc

Remar

8/12/2019 Appl Proforma

3/3