2012000478

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BioInformatics National Certification (BINC)

Examination Form - February 2012
Instituted by Department of Biotechnology, Government of India, New Delhi. Coordinated by School of Computational & Integrative Sciences, JNU, New Delhi, India.
(Paste photo above)

Personal Details
Full Name : Gender : Date Of Birth : Category : Nationality : Correspondence Address :
KUSHWAHA SATISH CHANDRA Male 25/05/1982 OBC Indian 91-A PANA UDYAN, JHANDA CHOWK

Application No : Centre :
Delhi

2012000478

SATISH CHANDRA KUSHWAHA, C/O SUKHBIR SINGH

City : State : Country : Permanent Address :

NARELA DELHI INDIA

District : Postal Code :

DELHI 110040

SATISH CHANDRA KUSHWAHA, S/O ASHOK KUMAR KUSHWAHA 61K/3B PUSHPANJALI NAGAR BHAVAPUR, POST-KARELI

City : State : Country : STD Code-Phone No : Email ID :

ALLAHABAD UTTAR PRADESH INDIA

District : Postal Code : Mobile No :

ALLAHABAD 211016 9555809985

satischand@rediffmail.com

Academic Details
Education : Subject : University : Year of Passing : Bioinformcatics Training
MSc Completed FOOD TECHNOLOGY ALLAHABAD UNIVERSITY 2005 Formal

Percentage :

67.0%

Demand Draft Details

DD No. : DD Amount :
39314 Rs.450 /-

DD Date : Bank Name :

06/01/2012 SYNDICATE BANK

Note: DD must be drawn in the favour of Finance Officer, Jawaharlal Nehru University, Payable at New Delhi. (Nationalised Bank Only). The following documents have been enclosed:
Printed and signed examination form. Attested copy of Caste Certificate (In case of Reserved Category). Applicable only for Indian students. One passport size photograph. "Write your name and application number on reverse." Demand Draft. "Write your name and application number on reverse."

Declaration:
- I hereby declare that information given in this form is correct, I shall be responsible for any incorrect information. - I understand that the fee is not refundable and not transferable.

Enclose the documents requested above in an A4 size envelope and send it by post to : The Coordinator, BINC Examination, Bioinformatics Centre, School of Computational & Integrative Sciences, JNU, New Delhi, India
(For office purpose only) (Signature) KUSHWAHA SATISH CHANDRA

Date : 07/01/2012 15:18:39

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07-01-2012

2012000478

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