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Instructions and Application Form For GATE 2012
Instructions and Application Form For GATE 2012
3. 4.
5. 6. 7.
8.
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____________End of Instructions____________
GATE COPY
INDIAN General No
11. Address for Correspondence KRISHNA VILASAM VEEDU K.V.ROAD EVRA 264 JAGATHY,THYCAUD.P.O 12. PINCODE of Address for 695014 Correspondence 13. Year of Degree 14. Discipline 15. Name of Parent 2010 Electrical Engg/Electrical and Electronics Engg./Power Engg M V SANKARAN KUTTY Kerala
7. Qualifying Degree
09995325711
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 contents of GATE 2012 website 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 2012. Further, if any such suppression or distortion of facts is found after appearing in the exam, any admission/degree acquired on the basis of GATE 2012 score is liable to be cancelled. Place : Date :
18. Signature
19. Photograph
Full Signature of the candidate using BLACK INK PEN only (do not sign in CAPITAL LETTERS)
3.5 cm x 3.5 cm
730EE7183913
Send this form along with the necessary documents to IIT Madras.
CANDIDATE COPY
INDIAN General No
11. Address for Correspondence KRISHNA VILASAM VEEDU K.V.ROAD EVRA 264 JAGATHY,THYCAUD.P.O 12. PINCODE of Address for 695014 Correspondence 13. Year of Degree 14. Discipline 15. Name of Parent 2010 Electrical Engg/Electrical and Electronics Engg./Power Engg M V SANKARAN KUTTY Kerala
7. Qualifying Degree
09995325711
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 contents of GATE 2012 website 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 2012. Further, if any such suppression or distortion of facts is found after appearing in the exam, any admission/degree acquired on the basis of GATE 2012 score is liable to be cancelled. Place : Date :
18. Signature
19. Photograph
Full Signature of the candidate using BLACK INK PEN only (do not sign in CAPITAL LETTERS)
3.5 cm x 3.5 cm
730EE7183913
BY SPEED / REGISTERED POST (Please do not Courier) GATE 2012 Application Form
730EE7183913
Do not tamper with the bar code. For GATE official use.
From
ATHISHA U S (APPLNO : 7183913) KRISHNA VILASAM VEEDU K.V.ROAD EVRA 264 JAGATHY,THYCAUD.P.O 695014
CASH VOUCHER
CANDIDATE COPY
Challan can be deposited minimum one day after the generation of challan.
Name of the Candidate : ATHISHA U S Address for Correspondence :
Challan can be deposited minimum one day after the generation of challan.
Name of the Candidate : ATHISHA U S Address for Correspondence :
Challan can be deposited minimum one day after the generation of challan.
Name of the Candidate : ATHISHA U S
KRISHNA VILASAM VEEDU K.V.ROAD EVRA Address for Correspondence : 264 JAGATHY,THYCAUD.P.O - 695014
09995325711 athishau@yahoo.com
09995325711 athishau@yahoo.com
09995325711 athishau@yahoo.com
General Rs.1025/- * Rupees One thousand and Twenty Five Only. (*Application Fees Including Bank Charges)
General Rs.1025/- * Rupees One thousand and Twenty Five Only. (*Application Fees Including Bank Charges)
General Rs.1025/- * Rupees One thousand and Twenty Five Only. (*Application Fees Including Bank Charges)
JOURNAL NUMBER
JOURNAL NUMBER
JOURNAL NUMBER
Signature of the Candidate/Remitter For Receiving Branch use only 1. Please note to write the Journal Number in all the challans. 2. Please feed the Application No. in REG/ID/Ref No. Column.
Signature of the Candidate/Remitter For Receiving Branch use only 1. Please note to write the Journal Number in all the challans. 2. Please feed the Application No. in REG/ID/Ref No. Column.
Signature of the Candidate/Remitter For Receiving Branch use only 1. Please note to write the Journal Number in all the challans. 2. Please feed the Application No. in REG/ID/Ref No. Column.
SEAL / DATE
AUTHORISED SIGNATORY
SEAL / DATE
AUTHORISED SIGNATORY
SEAL / DATE
AUTHORISED SIGNATORY