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. ^" ,eiatie proFesso;j" ^t,,,i,, ,,;:;poftrngnt _{of iooiogy}

Page 1 of 3

_-^{i*/est gpnggf} Stat** Unifrrsit:

^*-Barasat, (it)'tru_. _{Kot_la,}

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Barasat,"."oo"offi pin-700r26,wesrBengar'1t-#f,frlfJ:J:*YlrY"H:1fl

Form of Application for JRF/SRF/Laboratory Attendant

Recent passport size photograph of

(a) Position applied for ..........................r............................'.........r.r......... (in block letters) ^the candidate. (To

be attested by the applicant.)

(b) Advertisement No. .........c..o.....c................r...........r..........eotrrro.r............o.

To The Registrar West Bengal State University

Sir, With reference to your advertisement for the above-mentioned post, I present myself as an applicant for _{the same.} My biodata and other relevant documents are given below Yours faithfully

(Signature of the Applicont)

BIODATA 1.Name (in block letters) 2.Permanent Address (in block letters)*

3.Date of Birth* 4.Name of FatherAvlother 5.Nationality

6.Whether belonging to Scheduled Caste/Scheduled Tribe/ OBC (necessary documents _{to be attached)r YesA.,lo. T.Contact No. : 8.E-mail: 9.Detail of National Level Examination ^passed (if any)*:}

^{1 0.Educational qualifications* (arranged} chronologically, starting from Matriculation/s.F./H.s. or equivalent,

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^{Graduation' specifically mentioning Honours or Pass, Post-graduate Degrees, professional qualifications _{etc.) Examinations}}

School/College & Percentage of

^Passed & Year of Board/[Jniversity _-^Subjects studied Any other

marks

information

I l. Published pa	eer reviewed Journals* :
Title with page Nos.		ISSN / ISBN No.	Impact
			factor(if any)

Any other inft

13.

Particulars of extra-curriculum _{activities, if any}

14.

^{Name of the three referees} (with affiliation and contact _no.)

(i)

(ii)

(iii)

testimonials need _{to be submined with apprication form; originar copies}