C 104 T 33 Applicationform

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Zone/Scrutiny GATE 2019

3SC C104T33
C104T33 (Enrollment ID)

SHEETANSHU DEEPAK
(Full Name of the Applicant)

30 Sep 1993 Male SC


(D.O.B) (Gender) (Category)

Indian +91-9418498092 KAMAL KISHOR


National (Mobile Number of Parent/Guardian) (Name of Parent/Guardian)

Communication Address GATE Exam Details


village dharwin GATE Paper Code
post office pukhri
Chamba
Himachal Pradesh 176310
+91-9459254781 (Mobile No.)
ME
(Mechanical Engineering)
sheetanshudeepak05@gmail.com New Delhi, DL
(Exam City 1)

Qualification Details Greater NOIDA, DL


(Exam City 2)
B.Tech
Mechanical Engg. Gurugram, HR
(Exam City 3)
Graduated: Yes; Year of Graduation: 2015
arni university Zonal GATE Office Contact
kangra Chairperson, GATE
Himachal Pradesh 176401 Indian Institute of Technology Delhi
Hauz Khas, New Delhi 110016
Payment Details
Online Rs. 750.00
Payment Ref. No.: NHMP6634313850 01/09/2018

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. The
responsibility of following the GATE 2019 website and meeting various deadlines lies with me. 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 2019. Further, if any suppression or distortion of facts is found after appearing in the
exam, any admission/degree/benefit acquired on the basis of GATE 2019 score/marks is liable to be
cancelled.

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Fingerprint: 91a1bbb35194fc5a2b78ff3b03747531

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