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GATE2012_8066914

GATE2012_8066914

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Published by: shrutigpta on Oct 16, 2011
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8.Page - 4 : Address page to be pasted on a 10 inch X 12 inch size laminated envelope.7.
Instructions for the Candidate:
1.2.Page - 1: Instructions for the candidate to be retained by the candidate.3.4.5.a.Paste your recent color photo (3.5cm x 3.5cm) in the designated place. Before pasting, please writeyour name and application number on the backside of the photo with black ball point pen.6.There are 5 pages in this pdf file. These pages should be printed on A4 size white sheets using alaser/ink jet printer.Page - 2 : Application Form (GATE Copy).Page - 3 : Application Form (Candidate copy) to be retained by the candidate.
Instructions and Application Form for GATE 2012
1.Application Form (GATE Copy)2.Bank Challan (GATE Copy)3.Self Attested Copy of SC/ST/PD certificate (if applicable)4.Self Attested Copy of affidavit for change of name (if applicable)Your Login ID is SAUR010745. Remember your password and do not disclose it to anyone.Without folding, insert the completed Application Form (GATE copy) and attested copies of all theapplication documents (SC/ST/PD certificate, copy of degree certificate etc.) into a 10 inch X 12 inchlaminated envelope and send by Speed Post (preferably) or by Registered Post using the addressprinted on page-4 so as to reach the respective Zonal GATE office on or before 24th October 2011.
List of Documents to be attached with the Application Form:
5.Self Attested Copy of the degree certificate if the year of qualifyingdegree is 2011 or earlier.6.If the year of qualifying degree is 2012 or later, a certificate signed bythe principal of the college clearly indicating the year of qualifyingdegree (format available on GATE website).
 ____________End of Instructions____________ 
Application sent through courier will not be accepted.
Put
Page - 5 : Bank challan in triplicate. Take it to any SBI branch and pay the application fee plus the bankservice charge. The Bank will retain its copy and will return the remaining two copies to you. Out ofthese two copies, retain the Candidate's copy with you and attach the GATE copy with the ApplicationForm.b.Sign at the designated place.7.Candiates with backlog: copy of final semester/year marks sheet orcourse completion certificate or a letter from principal.
 
Mechanical EngineeringSAURABH KUMAR
Name of the Candidate as inthe 10th Class CertificateChoice of GATE Paper
1.9.
GATE COPYAPPLICATION NO.8066914
GATE 2012 APPLICATION FORM
Zone:IIT Roorkee
Payment Mode: Bank Challan (SBI)Fee:Rs. 1000
Date of Birth (DD/MM/YYYY)
2.
E-mail Address
kumarsaurabh.709@gmail.com01/07/199110.
Gender
3.MALE
Address for Correspondence
VILL+POST -MOHAN PUR11.KHAD MOHAN NAGARDIST- BULANDSHAHR
CategoryPerson with Disability (PD)NationalityYear of DegreeDiscipline
5.6.4.13.14.GeneralNoINDIAN2012Mechanical Engineering
PINCODE of Address forCorrespondence
12.245412
Qualifying DegreeChoice of Examination City1Choice of Examination City2Name of ParentState/Union Territory ofPermanent Residence
7.8.15.16.B.E./B.Tech./ B.Sc.(Engg.)/B.Sc.(Tech.)/B.Arch.806 - Ghaziabad818 - NoidaRAM KUMAR SHARMAUttar Pradesh
I hereby declare that all the particulars stated in this application form are true to the best of my knowledge andbelief. I have read the contents of GATE 2012 website and I shall abide by the terms and conditions therein. Inthe event of suppression or distortion of any fact in my application form, I understand that I will be denied theopportunity to appear in GATE 2012. Further, if any such suppression or distortion of facts is found afterappearing in the exam, any admission/degree acquired on the basis of GATE 2012 score is liable to becancelled.
Mobile / Landline No.
17.09719908437
Place :Date :
Full Signature of the candidate usingBLACK INK PEN only(do not sign in CAPITAL LETTERS)
806ME8066914
19.
Photograph
18.
Signature
3.5 cm x 3.5 cm
Send this form along with the necessary documents to IIT Roorkee.
 
Mechanical EngineeringSAURABH KUMAR
Name of the Candidate as inthe 10th Class CertificateChoice of GATE Paper
1.9.
CANDIDATE COPYAPPLICATION NO.8066914
GATE 2012 APPLICATION FORM
Zone:IIT Roorkee
Payment Mode: Bank Challan (SBI)Fee:Rs. 1000
Date of Birth (DD/MM/YYYY)
2.
E-mail Address
kumarsaurabh.709@gmail.com01/07/199110.
Gender
3.MALE
Address for Correspondence
VILL+POST -MOHAN PUR11.KHAD MOHAN NAGARDIST- BULANDSHAHR
CategoryPerson with Disability (PD)NationalityYear of DegreeDiscipline
5.6.4.13.14.GeneralNoINDIAN2012Mechanical Engineering
PINCODE of Address forCorrespondence
12.245412
Qualifying DegreeChoice of Examination City1Choice of Examination City2Name of ParentState/Union Territory ofPermanent Residence
7.8.15.16.B.E./B.Tech./ B.Sc.(Engg.)/B.Sc.(Tech.)/B.Arch.806 - Ghaziabad818 - NoidaRAM KUMAR SHARMAUttar Pradesh
I hereby declare that all the particulars stated in this application form are true to the best of my knowledge andbelief. I have read the contents of GATE 2012 website and I shall abide by the terms and conditions therein. Inthe event of suppression or distortion of any fact in my application form, I understand that I will be denied theopportunity to appear in GATE 2012. Further, if any such suppression or distortion of facts is found afterappearing in the exam, any admission/degree acquired on the basis of GATE 2012 score is liable to becancelled.
Mobile / Landline No.
17.09719908437
Place :Date :
Full Signature of the candidate usingBLACK INK PEN only(do not sign in CAPITAL LETTERS)
806ME8066914
19.
Photograph
18.
Signature
3.5 cm x 3.5 cm
Retain this copy with you for future reference.

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