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5/9/2014 ugcnetonline.in/viewForm.php?id=&jno= http://ugcnetonline.in/viewForm.php?id=&jno= 1/1 UGC - NATIONAL ELIGIBILITY TEST JUNE, 2014 Print Copy of Application Form (ONE COPY TO BE SUBMITTED TO THE COORDINATING INSTITUTION) To be Filled by the Coordinating Institution only Roll No.: 34171535 Ref.No.: 11587616 The particulars furnished by the candidate have been checked and verified University of Lucknow, Lucknow – 226 007(34) COORDINATING INSTITUTION __________________________ CO-ORDINATOR (Signature) Subject Code 17 Coordinating Institution Code 34 __________________________ OFFICE SEAL 1. Applied for : JRF and Assistant Professor Both 2. Subject opted for NET : Management 3. Name : Mr. MOHAMMAD FARAZ 4. Date of Birth (as recorded in matriculation or equivalent certificate) : 06-12-1987 5. (i) Sex : MALE (ii) Category : GEN 6. Visually Challenged / Physically Challenged : Not Applicable 7. Father's Name : Shri LATE-MOHAMMAD MUSHIR 8. Mother's Name : Sm t. SALMA KHATOON 9. Examination Appearing/Passed : MBA 10. Name of the University/Institution : Bharati Vidyapeeth 11. Marks/Grade : NA Mark Obtained : NA Total Marks : NA Marks in % : NA 12. Detail of Fee Deposited in State Bank of India Deposit Date : 07-05-2014 Fee Status : Paid Journal No. : 28804117 13. Candidate Phone No. : Mobile No. : 8087500570 14. Email : [email protected] Affix recent Passport size Photograph signed by the candidate and duly attested by the Head of Deptt. / Institution or Class-I Gazetted Officer (DO NOT USE STAPLER OR PIN) Declaration i) I, MOHAMMAD FARAZ, hereby declare that all statements made in the online application are true, complete and correct to the best of my knowledge and belief and in the event of any information being found false or incorrect or any ineligibility being detected before or after the test, my candidature is liable to be cancelled and legal action may be initiated against me. ii) I fulfill all conditions of eligibility regarding age limit, educational qualification etc. prescribed for the test. iii) I have gone through the conditions attached to NET and shall abide by the same. iv) I have deposited the required fee. v) I have noted that if my application is found incomplete/defective, the same is liable to be rejected summarily and no correspondence will be entertained in this regard. vi) I have read and agreed with the Notification for the UGC NET including instructions, enclosures, check list and other relevant information. Date: 01-05-2014 ___________________ Place: Pune Signature of Candidate

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Page 1: Ugcnetonline.in ViewForm

5/9/2014 ugcnetonline.in/viewForm.php?id=&jno=

http://ugcnetonline.in/viewForm.php?id=&jno= 1/1

UGC - NATIONAL ELIGIBILITY TEST JUNE, 2014

Print Copy of Application Form(ONE COPY TO BE SUBMITTED TO THE COORDINATING INSTITUTION)

To be Filled by the Coordinating Institution only

Roll No.: 34171535

Ref.No.: 11587616

The particulars furnished by the candidate

have been checked and verified

University of Lucknow, Lucknow – 226 007(34)

COORDINATING INSTITUTION

__________________________

CO-ORDINATOR (Signature)

Subject Code 17

Coordinating Institution

Code34

__________________________

OFFICE SEAL

1. Applied for : JRF and Assistant Professor Both

2. Subject opted for NET : Management

3. Name : Mr. MOHAMMAD FARAZ

4. Date of Birth (as recorded in matriculation

or equivalent certificate)

: 06-12-1987

5. (i) Sex : MALE (ii) Category : GEN

6. Visually Challenged / Physically

Challenged

: Not Applicable

7. Father's Name : Shri LATE-MOHAMMAD MUSHIR

8. Mother's Name : Smt. SALMA KHATOON

9. Examination Appearing/Passed : MBA

10. Name of the University/Institution : Bharati Vidyapeeth

11. Marks/Grade : NA

Mark Obtained : NA Total Marks : NA Marks in % : NA

12. Detail of Fee Deposited in State Bank of India

Deposit Date : 07-05-2014

Fee Status : Paid

Journal No. : 28804117

13. Candidate Phone No. : Mobile No. : 8087500570

14. Email : [email protected]

Affix recent Passport sizePhotograph signed by the

candidate and dulyattested by the Head of

Deptt. / Institution orClass-I Gazetted Officer

(DO NOT USE STAPLEROR PIN)

Declarationi) I, MOHAMMAD FARAZ, hereby declare that all statements made in the online application are true, complete and correct to the best of my

knowledge and belief and in the event of any information being found false or incorrect or any ineligibility being detected before or after the

test, my candidature is liable to be cancelled and legal action may be initiated against me. ii) I fulfill all conditions of eligibility regarding age

limit, educational qualification etc. prescribed for the test. iii) I have gone through the conditions attached to NET and shall abide by the same.

iv) I have deposited the required fee. v) I have noted that if my application is found incomplete/defective, the same is liable to be rejected

summarily and no correspondence will be entertained in this regard. vi) I have read and agreed with the Notification for the UGC NET

including instructions, enclosures, check list and other relevant information.

Date: 01-05-2014 ___________________

Place: Pune Signature of Candidate