Full Name (as per official records)* must provide value
Date of Birth* must provide value
D-M-Y
Gender * must provide value
Male Female Others
Email ID* must provide value
All important communication will be sent to this email id
Country Code* must provide value
E.g. 91 for India, 1 for USA, Do not put plus (+)
Mobile Number* must provide value
Insert Mobile Number (E.g. 9845000000)
Country Code E.g. 91 for India, 1 for USA, Do not put plus (+)
STD (State) Code Insert STD Code only (E.g. 80, 44)
Alternative Phone Number Insert Phone Number only (E.g. 49467099)
Father's / Mother's / Spouse's / Guardian's Name * must provide value
Provide any one
Whose name have you inserted?* must provide value
Father's Mother's Guardian's Spouse's
Present Address* must provide value
Flat No./Name, Colony Name, Street/Cross/Road, Area/PO, Landmark, City.
State / UT of Residence* must provide value
1. Andhra Pradesh 2. Arunachal Pradesh 3. Assam 4. Bihar 5. Chhattisgarh 6. Goa 7. Gujarat 8. Haryana 9. Himachal Pradesh 10. Jharkhand 11. Karnataka 12. Kerala 13. Madhya Pradesh 14. Maharashtra 15. Manipur 16. Meghalaya 17. Mizoram 18. Nagaland 19. Odisha 20. Punjab 21. Rajasthan 22. Sikkim 23. Tamil Nadu 24. Telangana 25. Tripura 26. Uttarakhand 27. Uttar Pradesh 28. West Bengal 29. Andaman & Nicobar Islands 30. Chandigarh 31. Dadra & Nagar Haveli 32. Daman & Diu 33. NCT of Delhi 34. Jammu & Kashmir 35. Ladakh 36. Lakshadweep 37. Puducherry 38. Others
Pincode* must provide value
Nationality* must provide value
Indian Others
Which Category do you belong?* must provide value
General Scheduled Caste/Scheduled Tribe (SC/ST) Person with Disability (PwD)* Other Backward Classes (Non-Creamy Layer)
*PwD: As per The Rights of Persons with Disabilities Act, 2016.
Do you hold a valid and active Fellowship? * must provide value
Yes No
Type of Valid/Active Fellowship* must provide value
UGC-CSIR-NET JRF ICMR -JRF DBT-JRF Category 1 Other UGC-Recognized Fellowships with Stipend
Date of obtaining Fellowship* must provide value
D-M-Y
Which division are you applying for? * must provide value
Bio-statistics Health and Humanities Infectious Disease Molecular Medicine Nutrition Mental Health and Neurosciences Public Health and Epidemiology
Which division are you applying for? * must provide value
Molecular Medicine Nutrition Public Health and Epidemiology
Please select your Completed Degree:-* must provide value
MBBS, BDS or an undergraduate degree which is of at least 5 years' duration in different branches of Life sciences
Master's Degree in different branches of Life sciences (includes Biology, Pharmacy, Health, Informatics, Veterinary, Dentistry, Food Sciences, Nursing, Psychiatric Nursing, Genetics, Nutrition, Biotechnology, Bioinformatics & Biochemistry)
MSc in Epidemiology/Clinical Epidemiology
MSc or MPhil in Statistics or Bio-Statistics
Master's in Public Health (MPH)
Master's Degree in different branches of Social Sciences (includes Psychology, Psychiatry, Social Work, Ethics, Media, Humanities, Philosophy, Indigenous studies & Anthropology)
MTech in Biotechnology
MPhil in different branches of Life sciences (includes Biology, Pharmacy, Health, Informatics, Veterinary, Dentistry, Food Sciences, Nursing, Psychiatric Nursing, Nutrition, Bioinformatics, Biotechnology & Biochemistry)
MPhil in Epidemiology/Clinical Epidemiology
MPhil in Law or different branches of Social Sciences (includes Psychology, Social Work, Ethics, Media, Humanities, Philosophy, Indigenous studies & Anthropology)
Master of Hospital Administration (MHA)
Master of Physical Therapy (MPT)
MD in any subject (including Community Health and Psychiatry)
Year of Completing Degree* must provide value
2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990
Obtained till 15th April 2021
University / Institute* must provide value
Please put full name and no abbreviations
Cumulative Percentage of Marks or Grade obtained * must provide value
Please enter as "80" for "80%"
Are you currently employed?* must provide value
Yes No
Institution or Organization of Work * must provide value
Recent Colour Passport-Sized Photograph of Applicant * must provide value
Applicant's Latest Curriculum Vitae (CV) / Bio-data * must provide value
Highest Degree Certificate* must provide value
Highest Degree Cumulative Marks Card* must provide value
Valid Fellowship (Award) Certificate * must provide value
Government Issued ID Proof with Date of Birth* must provide value
Relevant Category Certificate* must provide value
* must provide value
I hereby declare that the information provided by me in this application form is true to the best of my knowledge. Further, I agree to abide by the instructions, and terms and conditions provided in the Website.
Date/Time Now D-M-Y H:M:S
Working...