UGC - National Eligibility Test December, 2014
Print Copy of Application Form
(ONE COPY TO BE SUBMITTED TO THE COORDINATING INSTITUTION)
To be Filled by the Coordinating Institution only
The particulars furnished by the
candidate have been checked and
verified
Roll No.: 05081452
BANARAS HINDU UNIVERSITY, VARANASI 221
005.(05)
COORDINATING INSTITUTION
Subject Code
08
Coordinating Institution
Code
05
CO-ORDINATOR (Signature)
OFFICE SEAL
1. Applied for
: BOTH(JRF & ASSISTANT PROFESSOR)
2. Subject opted for NET
: COMMERCE
3. Name
: SONIA SARFARAZ
Photograph signed by the
candidate and duly
4. Date of Birth (as recorded in matriculation or : 24/08/1984
equivalent certificate)
attested by the Head of
Deptt. / Institution or
5. Gender
: FEMALE
6. Category
: GENERAL
7. Visually Challanged / Physically Challenged
: NO
8. Father's Name
: SARFARAZ AHMAD
9. Mother's Name
: KANIZ FATIMA
10. Examination Appearing/ Passed
: M.COM.
11. Name of the University/ Institution
VEER BAHADUR SINGH PURVANCHAL
: UNIVERSITY, JAUNPUR-222 002 (STATE
UNIVERSITY).
12. Marks/ Grade
: MARKS
Marks Obtained
: 542
Affix recent Passport size
Class-I Gazetted Officer
(DO NOT USE STAPLER
OR PIN)
Total Marks
: 900
% of Marks
Obtained
: 60.22
13. Fee Payment Details
Payment Mode : Debit/Credit Card
Exam Fee Amount (Rs.) : 450 /-
Transaction ID : ASMP3555667679
Date of Transaction : 14-11-2014 18:59:03
Card Type : VISA/Master Card
14. Phone No.
: NA
15. Email
: SURESHVARANASI2008@GMAIL.COM
Mobile No.
: 9919543393
Declaration
i) I, SONIA SARFARAZ 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 entrtained 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: 11/14/2014 6:53:22 PM
Place:
Signature of Candidate