Page 1 of 4
NATIONAL AGRI-FOOD BIOTECHNOLOGY INSTITUTE (NABI)
(Dept. of Biotechnology, Ministry of Science & Technology, Govt. of India)
C-127, Industrial Area, Phase VIII, S.A.S. Nagar, Mohali -160 071(Pb), India
Website: www.nabi.res.in Tel: 0172-2290100; Telefax: 0172-4604888
FORM OF APPLICATION FOR SCIENTISTS / ENGINEERS / PROFESSIONALS
To be filled in by the candidate For Office use
Particulars of application D.D. for Rs._______
Advt.No._____________ fee (Rs.)_____________ REMOVED
Affix your recent
coloured passport
For Manager (Admn.) size photograph
Post applied D.D.No. _____________
for______________ Date ________________
Rectt. Section
Area of Specialization Name of the Issuing bank Date_________
____________________ & Branch_____________
____________________ ____________________
_______ ____________
1. Name in full (IN BLOCK LETTERS) ……………………………………………………………….
(In the case of female candidate, the appropriate prefix 'Miss' or 'Mrs' should be used)
2. Father's Name …………………………….Mother’s Name……………………………….
Husband's Name……………………………………………………………….
3. Date of Birth (DD/MM/YYYY)……………………Place of Birth……………………………..…
Age as on 31st March, 2011: …………yy……….mm………….dd
4. Postal Address…………………………………………………………………....................….…
……………………………………………………………………………………………………….
……………………………………………………………………………………………………….
……………………………………………………………………………………………………….
…………………………………………………………………PIN CODE………………………….
Phone No:(with STD code)…………………………...…..Mobile No……………………………..
E-mail ID………………………………………………………………………….……………………
Permanent Address.…………………………………………….....................…………………….
……………………………………………………………………………………………………….
……………………………………………………………………………………………………….
……………………………………………………………………………………………………….
……..…………………………………………..………………PIN CODE……….....………….…
Page 2 of 4
5. Are you a citizen of India by birth or by domicile?………………….……
6. Name of State to which you belong: ………………………..................................
7. State whether you are a member of Scheduled Caste/Scheduled Tribe/ SC
Other Backward Class. If so, attach an attested copy of the prescribed ST
certificate in support of your claim, OBC
(Tick the appropriate Category) GEN
PH
8. Are you related to any employee(s) of the DBT / NABI? If so, give details:
…………………………………….………………………................….……
9. Educational/ Professional Qualifications:
Exam. Division/ Year of Duration of the Board/Univer Subject(s)
Passed Grade & % age Passing Degree, etc. sity
of marks
10. Details of employment (in chronological order):-
Organization Post Scale of pay Exact dates to Total Nature of duties
Held and last pay be given period (in
drawn years)
From To
11. Any additional qualification such as membership of professional societies; awards and
honours etc.……………………………………………......................................
Page 3 of 4
12. Topic of Ph.D/Higher Degree thesis
13. List of papers published along with impact factor, citations and h-factor
14. Three best publications:
15. Name and address of 3 references (Confidential evaluation may be arranged to be sent to
rakeshtuli@hotmail.com)
1.
2.
3.
16. Pl. give 100 words plan of your work / vision for NABI on the given space below or attach a
separate sheet)
Page 4 of 4
17. Are you willing to accept the minimum initial pay of the scale? If not, state what is the lowest
initial pay that would you accept in the prescribed pay-band: ......................…………………
18. Time period required for joining
19. Any other information
20. List of enclosures
DECLARATION BY THE CANDIDATE
I, _______________________, hereby declare that the statements made in the application
are true, complete and correct to the best of my knowledge and belief and in the event of any of
the information being found false or incorrect or any ineligibility being detected before or after the
selection, my candidature is liable to be cancelled and action may be initiated against me.
Place: Candidate's signature_________________
Date: Full name__________________________
Endorsement by the Head of the Department or Office
Candidate already employed should get the following endorsement signed by his/her present employer.
No. Date…………………
Forwarded application of Dr./Shri/Ms________________________________________
(Name & Designation). It is certified that :
1. The information furnished by Dr./Shri/Ms.……………………………………………….has
been verified from official records and found correct.
2. It is also certified that no disciplinary/departmental enquiry is either pending or
contemplated against ………………................. and that he/she is not undergoing any
penalty.
3. His/her integrity is certified.
Full Signature……..…………………..……
Designation……….………………………..…
Stamp...........................................................
