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230 H 101 Q Application
230 H 101 Q Application
230 H 101 Q Application
7FF
To
GATE 2013
Chairman GATE Indian Institute of Technology Madras Chennai, 600036
From V R Jyothsna
RAGHUNATHAPURAM VILLAGE ILLUPUR POST TIRUTTANI TALUK THIRUVALLUR DIST Tamil Nadu, 631204
230 H 101 Q
95783 36199
(Mobile No.)
Cut Here
Note: Application ID - 230 H 101 Q. You should preserve this number for further correspondence.
Zone/Scrutiny Code
7FF
230 H 101 Q
4.5 cm x 3.5 cm
(Application ID)
V R Jyothsna
(Full Name of Applicant)
230 H 101 Q
05 Jun 1992
(D.O.B)
Female
V Ravikumar
(Name of Parent)
GEN
Indian National
Communication Address
RAGHUNATHAPURAM VILLAGE ILLUPUR POST TIRUTTANI TALUK THIRUVALLUR DIST Tamil Nadu, 631204 India
Chennai South, TN
(Exam City 1)
Chennai North, TN
(Exam City 2) Scribe Assistance Required:
No
Qualification Details
B.E. Electronics/Comm./Telecomm Engg. Graduated: No, Year of Graduation: 2013 INDIRA GANDHI COLLEGE OF ENGINEERING AND POST ATHUR CHENGALPATTU Tamil Nadu, 603101
I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. I have read the Information Brochure and I shall abide by the terms and conditions therein. In the event of suppression or distortion of any fact in my application form, I understand that I will be denied the opportunity to appear in GATE 2013. Further, if any suppression or distortion of facts is found after appearing in the exam, any admission/degree acquired on the basis of GATE 2013 score is liable to be cancelled.
Date: ....../....../............
Principal Certificate
(For use as the eligibility certificate only for final year or backlog applicants)
This is to certify that V R Jyothsna is a student enrolled in INDIRA GANDHI COLLEGE OF ENGINEERING AND TECHNOLOGY FOR WOMEN, POST ATHUR CHENGALPATTU. She is a student of the final year of B.E.. She appeared in the final semester/year exam of the above degree, but has a backlog to be cleared from an earlier semester/year, and therefore cannot produce a course completion certificate.
Date:
Seal