Professional Documents
Culture Documents
1CD
To
GATE 2013
Chairman GATE Indian Institute of Science, Bangalore Bengaluru, 560012
From Jayakumar L
84 6TH CROSS BRINDHAVANAM PUDUCHERRY Pudicherry, 605013
231 S 787 W
91592 81670
(Mobile No.)
Cut Here
Note: Application ID - 231 S 787 W. You should preserve this number for further correspondence.
Zone/Scrutiny Code
1CD
231 S 787 W
4.5 cm x 3.5 cm
(Application ID)
Jayakumar L
(Full Name of Applicant)
231 S 787 W
30 Oct 1985
(D.O.B)
Male
(Name of Parent)
GEN
Indian National
Lakshmikanthan K
Communication Address
84 6TH CROSS BRINDHAVANAM PUDUCHERRY Pudicherry, 605013 India
Bengaluru, KA
(Exam City 1)
Mysore, KA
(Exam City 2) Scribe Assistance Required:
No
Qualification Details
B.Tech Mechanical Engg. Graduated: Yes, Year of Graduation: 2007 PONDICHERRY ENGINEERING COLLEGE PUDUCHERRY Pudicherry, 605011
Enclosure Checklist
Eligibility Certificate copy Stamped Bank Challan: GATE copy
Payment Details
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: ....../....../............