ICAR-IIAB Biotech, Life Science, Genetics & Plant Breeding SRF Recruitment, Attend Walk-In

Page 1

F.No.:IIAB/8(1)/2022-23/27

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ICAR-INDIAN INSTITUTE OF AGRICULTURAL BIOTECHNOLOGY Garhkhatanga, Ranchi – 834 003
Dated: 02/06/2023 Advertisement:02/2023-24 Annexure I
(A) General Information: 1. PostAppliedfor(giveSl.No.) Pasterecent passportsize photograph dulyselfattested 2. FullName(inBlockletters) 3. Father’s/Husband’sName 4. Gender Male/Female/Others 5. DateofBirth(DD/MM/YY) …….……/…………../……………. 6. Ageason…………. asondateofInterview ………..….years…….…….months…………..days 7. MaritalStatus Married/Unmarried 8. ContactNo. Mob.No. 9. E-mail Alternate-mail 10. CorrespondenceAddress 11. PermanentAddress 12. Category General/EWS/OBC/SC/ST/PH (B) Academic Qualification: S. No Nameof degree Subjects/ specialization Board/ University Yearof passing Duration ofCourse (inyears) Max. Mark/ OGPA Marks/ OGPA obtained % 1. 10thclass/ equivalent 2. 10+2/Higher Secondary equivalent 3. Bachelor’s Degree 4. Master’s Degree 5. Ph.D 6. Other (specify)
PROFORMAOFAPPLICATIONFORMFORENGAGEMENTOFSRFUNDERNASFPROJECT

(C) Publications details (Best five publications)

(D) Experience (duly supported with certificates issued by Concerned Employers)

(E) Please state whether you are employed at present: Yes / No

If yes, then give details of Employer with full Address and produce No Objection Certificate

(F) Additional information, If any:

DECLARATION

I…………………………………………………………… do hereby declare that all the statements made in this applicationaretrue,complete,andcorrecttothebestofmyknowledgeandbelief.Iunderstandandagreethatinthe eventofanyinformationbeingfoundfalse/incorrect/incompleteorineligibilitybeingdetectedatanytimebefore oraftertheinterview/selection,mycandidature/appointmentmaybecanceledorisliabletoberejectedwithoutany notice.

Date&Place: (Signature) FullNameoftheCandidate

1)
2) 3)
Sr. No. Designation Nameofthe Employer Periodofexperience No.of years/ months Natureofwork done Fromdate Todate
Chronologicallistofexperience
1. 2. 3. 4.

Advertisement:02/2023-24

DECLARATION

(To be submitted in advance by candidates whose relative(s) is an employee of ICAR/ICAR-IIAB; other candidates will furnish it at the time of Interview)

I........................................................................, declare that none of my near or distant relative(s) is an employeeoftheIndianCouncilofAgriculturalResearch(ICAR)/ICAR-IIAB,Ranchi,India.

I...................................................................... declare that I am related to the following individual (s) employedinICAR/ICAR-IIAB,Ranchi,who’sName(s),designation,natureofduties,andrelationship withmearefurnishedbelow.

Name:

Designation:

Institute/Organization:

Natureofduties:

If the above-cited information is found to be incorrect or concealing any facts, my candidature for the interview/selectiontothepostisliabletobecancelled.

Signature………………………..

FullNameoftheCandidate…………………………………

DateandPlace………………………………………………

Annexure II
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