Application No.
(For office use only)
NATIONAL INSTITUTE OF PHARMACEUTICAL EDUCATION & RESEARCH
67,
. ग ,
. .
-160062.
APPLICATION FORM FOR THE POST OF JUNIOR RESEARCH FELLOW (TO BE FILLED BY THE APPLICANT IN BLOCK LETTERS, NO PART OF THE FORM SHOULD BE LEFT BLANK )
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Post Applied for:
Junior Research Fellow under Project GP-435 under Dr. Ipsita Roy, Associate Professor, Department of Biotechnology, NIPER, SAS Nagar
1.
Fee Paid:
Rs.
Date
2.
Name of the applicant
Single
Male
Married
3.
Father’s Name
4.
Address: Present (for communication)
/ Husband’s Name
/
:
Please affix a recent passport size photograph
/
Female
(please tick)
PIN 5.
Address: Permanent
PIN E-Mail: Mobile No.: Day
6.
Date of Birth
8. 9.
Nationality: Present Employment:
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