BIO–DATAFORMATFORRESEARCHASOCIATESHIP/RESEARCH FELLOWSHIP
DRL,Tezpur,Assam-784001
Nameofthecandidate : (Inblockletters)
Father’sName : 3.PermanentAddress : 4. CommunicationAddress : 5. ContactDetails:MobileNo……………………………… Email:………………………………….
RequiredQualificationwithdiscipline: 7. Detailsof NET/GATEQualification:
Ageasonclosingdateofapplication:
Agerelaxation,ifany&reasonthereof:
ListofselfattestedDocumentsenclosed i) ii) iii)
ofcandidate
:
attested Passport photo
1.
2.
6.
8.
9.
10.
Signature
Place: Date
Self