IISc-CBR Brain Research - Life Science Job Openings

Centre for Brain Research An autonomous Centre of the Indian Institute of Science SID Complex, Indian Institute of Science Bangalore – 560 012 Email: office.cbr@iisc.ac.in Ph. No. : +91 2293 3588

APPLICATION FOR RECRUITMENT Post Applied for 1. Name in Full First Name Middle Name Last Name 2 Sex MALE 3. Marital

FEMALE

OTHERS

Status MARRIED

4. Date of Birth:

SINGLE

5. Nationality: D

D

M M

Y

Y

Y

Y

6. Address for communication: Present

7. Mobile Telephone No.

8. Email Id:

9. Academic record: (please attach xerox copies of certificate) Course College / University / Institute Year of Joining

Year of Leaving

Percentage

Class / Division

10. Employment (Particulars of your past position(s) Employer

Position held

Date of Joining

Date of Leaving

Pay with Scale of pay

11. Professional Training Received Year

Nature of Training

Duration

Organization where training was provided

12. Membership of Professional Bodies Name of the Body

Status of Membership: Life/Annual

13. Names and addresses of three References (at least one of them should be familiar with your recent work) Name Occupation or Position Address

E-mail Phone No

14. Statement of Objectives a. Please indicate as to why you wish to join CBR Bengaluru.

b. How in your opinion do you meet the job requirements as advertised?

I hereby declare that all the details furnished above are true to the best of my knowledge and belief.

Date: Place: Signature of the applicant