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A F P L I CA
CSIR-INSTITUTE OF HIMALAYAN BIORESOURCE TECHNOLOGY Palampur, (H.P.)-176 061 11 0 N F 0 ~ fV\ 0 R : .r R F /5 f(, F) PR ojE C T
r:
FELL 0 N
·" t'Ion f or t he P 't'Ion 0f : APP Ilea , 051 Ref: Advt. No.
--
~
_
PI. attach your recent passport size photograph self attested
1. Name of Position applied for
2. Position No.
..
3. Name of Candidate (in Block Letters)
4. Father's Name 5. Mother's Name
6. Date of Birth(DOB) ,
.
7; Address for Communication
Telephone No. with STD Code
-'--
Mob.No.
_
e-mail address:
_
8. Permanent Address
- '"
Telephone
Mob.No.
No, with STD Code,
_
e-mail address: 9. Educational
, Examination
Qualifications
_ th
in tabular form from 10
Subject(s)
Marks Securedl Max. Marks
Class onwards:
%of Marks/Rank ICGPAlOGPA
University
Year
10m "
I-----
10+2
B.Sc. BE/B.Tech. M.Sc.
-----"----
ME/M.Tech.
Ph.D
I Contd ... 2
-2-
10. Technical Qualification,if any (Not covered under COL9)
11. Experience,
as per following
Sr. Name of Department! No. Organization 1 2
details:
Post(with Pay)
From
3
12. Whether belong to SC/ST/OBC/PH
To
Tots ' period
Nature of duties
5
6
4
:
_
13.Whether you have any blood relation : working in CSIR-IHBT.lf so, give details(his/her post/rank in CSIR-IHBT,Palampur.)
_
14. Any other details
.1 hereby declare that all the statements to the best of my knowledge information disqualification
found
false
or
made in the applic:";')n
and belief and nothing incorrect
,.
of my candidature
at any
time,
are correct and complete,
has been concealed. action
may
In the event of any
be taken
against
(Signatures) Name:
_
Place:
_
Encls: PI. attach the documents as per details mentioned
for
for the post applied for and I shall abide by the decision of the
Institute.
Date:
me
above.