Application Form

Page 1

Application No.

(For office use only)

NATIONAL INSTITUTE OF PHARMACEUTICAL EDUCATION & RESEARCH SECTOR-67, SAS NAGAR MOHALI- 160062

APPLICATION FORM FOR THE POST OF SENIOR RESEARCH FELLOW (TO BE FILLED BY THE APPLICANT IN BLOCK LETTERS, NO PART OF THE FORM SHOULD BE LEFT BLANK)

Advertisement No.:

Advt.No. 10 /2021

Post Applied for:

Senior Research Fellow under Project GP-453 Under Dr. K.B. Tikoo in the Department of Pharmacology & Toxicology

1.

Fee Paid:

Rs.

2.

Name of the applicant

Married

Date

Single

3.

Father’s Name

4.

Address: Present (for communication)

/ Husband’s Name

/

:

Male

/

Female

Please affix a recent passport size photograph

Transgender

(please tick)

PIN 5.

Address: Permanent

PIN Fax: E-Mail: Telephone:

Office: Day

6.

Date of Birth

8. 9.

Nationality: Present Employment:

Residence: Month

Designation: Organisation: Date of Joining: Pay Scale / Pay Band (PB) Pay in PB + Grade Pay (GP) / AGP Total Emoluments (Per month)(Rs.):

Year

7.

Age as on closing: Years/months/days date of applications


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