International Centre for Genetic Engineering and ... - ICGEB

taxmanstrongBiotechnology

Dec 11, 2012 (4 years and 11 months ago)

162 views

International Centre for Genetic Engineering and Biotechnology (ICGEB)

Post Box No. 10504, Aruna Asaf Ali Marg, New Delhi


110067








Ph.D. Entrance Test Application Form 20
1
1
-
201
2



1.

Stream (Please mark


on your choice of stream):




Human Health



Plant Science



2.

Personal Information




Name: _______________________________________________________
______________



Father’s/Mother’s Name:________________________________
_________
___________



Address: ______________________________________________________
_____________






______________________________________________________
____________


Mobile:

________________________

Email : ________________________
____________





Nationality _________________________________________________
_____________



Date of Birth:


______________________

Male/Female: ______________
______





Category: General /SC / ST

/ OBC/PH __
_________________
_____________
___________


3.

Academic Information

(
From Graduation onwards
)

Do not attach any
copy of
mark
sheet
/certificate



Degree

Year

Institute

Subject

Division

Percentage














4.

JRF Validity (Year) and the agency
;

(Attach

JRF

Certificate)



_____________________________________________________________





Signature____________________








Date: ___________________



Enclosure
Checklist:


(1)

Draft


(2)

JRF Certifica
t
e