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UGC - NATIONAL ELIGIBILITY TEST JUNE, 2012 Print Copy of Application Form

(TO BE SUBMITTED TO THE TEST CENTRE IN DUPLICATE)

To be Filled by the Test Centre only


Roll No. 46170872

The particulars furnished by the candidate have been checked and verified

Osmania University, Hyderabad-500 007(46) UNIVERSITY TEST CENTRE

__________________________ CO-ORDINATOR (Signature)


Affix recent Passport size Photograph signed by the candidate and duly attested by the Head of the Deptt./Institution or Class I Gazetted Officer (DO NOT USE STAPLER OR PIN)

Subject Code Centre Code

17 46 __________________________ OFFICE SEAL

NET Examination Detail


1. 2. (i) 2. (ii) 3. 4. Applied for Post Graduation Examination Subject of PostGraduation Subject opted for NET Centre of Examination : : : : : JRF and Lectureship Both Appearing/Appeared in Final Year of PG Management Management Osmania University, Hyderabad500007(46)

Personal Information
5. 6. Name (as per Hr. Sec. Matriculation Certificate Date of Birth (as recorded in matriculation or equivalent certificate) : Mr. D GOWRI SHANKAR

21-01-1988

7.

Sex Whether relaxation in age is sought

: : : :

MALE No ST Not Applicable

8. 9.

Category Visually Handicapped (V/H) / Physically Handicapped (PH) Father's Name Mother's Name Address for Communication Permanent Address

10. (i) 10. (ii) 11.

: : :

Shri D LAKPATHI Smt. D LALITHA S.SRINIVAS, H.NO: 1-12-63,VINAYAK NAGAR, NIZAMABAD, ANDHRA PRADESH, INDIA, 503003 H.NO 6-115,ANJINAPURAM (VILLAGE), PINAPAKA PATI NAGAR (POST), BURGAMPHAD(MANDAL) , KHAMMAM , ANDHRA PRADESH, INDIA, 507114

12.

Detail of Educational Qualification


13. (a) 13. (b) 13. (c) 13. (d) 13. (e) 13. (f) Examination Appearing/Passed : MBA Name of the University : Telangana University Year of Passing : NA Subject Offered : NA Specialization ( if any ) : NA Marks/Grade : NA Mark Obtained : NA Total Marks : NA % of marks obtained : NA

Passed M. Phil: No

Passed Ph. D.: No

14.

Detail of Fee Deposited


Name of the Bank Name of the Branch Branch Code Journal No. Deposit Date Amount : : : : : : STATE BANK OF INDIA VINAYAK NAGAR 11986 019467324 25-04-2012 Rs. 110

15.

The State/UT which you : Andhra Pradesh(01) belong

Place: Date: Email:

NIZAMABAD 25-04-2012 gowri.mars@gmail.com

Phone No. (with STD Code) Mobile No.: 9290612159

Declaration
i) I, D GOWRI SHANKAR, hereby declare that all statement made in this 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 agree with the Notification for the UGC NET including instructions, enclosures, check list and other relevant information.
Signature of Candidate________________

UGC - NATIONAL ELIGIBILITY TEST FOR JUNIOR RESEARCH FELLOWSHIP AND ELIGIBILITY FOR LECTURESHIP JUNE, 2012
ADMISSION CARD (PROVISIONAL) (TO BE SUBMITTED TO THE TEST CENTRE)
Test Centre: Venue of Test:
(To be filled by the Test Centre only)

Osmania University, Hyderabad-500 007(46) Roll No. 46170872

Subject: Name of the Candidate: Father's Name: Mother's Name: Address for Correspondence: Pin: Date of Test Timings Paper-I, Paper-II Paper-III

Management Mr. D GOWRI SHANKAR Shri. D LAKPATHI Smt. D LALITHA

Code: 17

S.SRINIVAS, H.NO: 1-12-63, VINAYAK NAGAR, NIZAMABAD, ANDHRA PRADESH, INDIA 503003 : Sunday; Jun. 24, 2012 Affix recent Passport size Photograph signed by the candidate and duly attested by the Head of the Deptt./Institution or Class I Gazetted Officer (DO NOT USE STAPLER OR PIN)

: 9:30 A.M. - 10:45 A.M., 10:45 A.M. - 12:00 Noon : 01:30 P.M. - 04:00 P.M.

NOTE(1) No TA will be paid for appearing in the Test (2) Entry to the Examination Hall will not be allowed without this card. (3) Cellular phone/Mobile/Pager/Calculator /Log Tables etc. shall not be allowed in the Examination Hall/Room. SIGNATURE OF CO-ORDINATOR ________________

Signature of Candidate _____________________

UGC - NATIONAL ELIGIBILITY TEST JUNE, 2012 ATTENDANCE SLIP FOR USE AT THE TEST CENTRE
(TO BE SUBMITTED TO THE TEST CENTRE FOR USE ON THE DAY OF EXAMINATION) (DATE OF TEST :Sunday; Jun. 24, 2012)
Roll No. 46170872 NAME: SUBJECT: Mr. D GOWRI SHANKAR Management SUBJECT CODE: 17

PAPER PAPER-I PAPER-II PAPER-III

TIMING 9:30 A.M. TO 10:45 A.M. 10:45 A.M. TO 12:00 Noon 01:30 P.M. TO 4:00 P.M.

* SIGNATURE OF CANDIDATE (IN EXAMINATION HALL)

Affix recent Passport size Photograph signed by the candidate and duly attested by the Head of the Deptt./Institution or Class I Gazetted Officer (DO NOT USE STAPLER OR PIN)

SIGNATURE OF CO-ORDINATOR ________________ Signature of Candidate _____________________ NOTE: This attendance slip should be retained by the Co-ordinator and must be given to the Invigilator for verification with Roll Number issued to the candidate. * The signature of the candidate should be taken on the day of examination.