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CSIR-CCMB Dissertation Research Training Programme
1. Full Name of the Candidate :            
2. Father's name :
3. Date of birth (dd-mm-yyyy) :
4. Gender :
5. Nationality :
6. Marital status :
7. Permanent address :
City:
8. Address for Correspondence :
City:

9. Email :
10. Telephone :

11. Educational Qualifications
Examination University Year of pasing Subjects Marks (%) Special Subjects
S.S.C / 10thStandard
12thStandard or equivalent
Bachelor`s Degree
Pursuing Degree University Year of Joining
(Note:Fill the below details as per applicable)
Semester/Year Subjects Marks(%) Special Subjects / Electives
I
II
III
IV
V
VI
VII
12. Have you already taken the consent of CCMB Scientist? :
13. Statement of Purpose :
14. Period of Dissertation (dd-mm-yyyy) : From:   To:
15. Whether the College/University is Recognised by UGC. :
16.Upload Authorization Letter from the University/College/Institute: : Upload the File in the next Step.
Declaration
I hereby declare that I have carefully read and understand the rules and regulations of the Dissertation Research Training Program offered at CSIR-CCMB, and the enties made in this application from are correct to the best of my knowledge and belief.

   
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