Professional Documents
Culture Documents
2CD
To
GATE 2014
A105K99 Chairperson GATE Indian Institute of Technology Bombay Powai, Mumbai 400076
A105K99
Note: Enrolment ID - A105K99. You should preserve this number for further correspondence.
Zone/Scrutiny
GATE 2014
2CD
A105K99
(Enrolment ID) (Full Name of the Applicant)
A105K99
A105K99
3.5 cm x 4.5 cm
A105K99
11 Jul 1991
(D.O.B)
Male
(Gender)
OBC
(Category)
No
(PD Status)
Indian National
9824114012
(Parent's Mobile Number)
Prakash
(Name of the Parent)
Communication Address
A/106 SUKHSHANTI APARTMENT WYKES COMPOUND,B/H 7 SEAS MALL FATEHGUNJ VADODARA Gujarat 390002
ME
Vadodara, GJ
(Exam City 1)
Anand, GJ
(Exam City 2)
Qualification Details
B.E. Mechanical Engg. Graduated: Yes; Year of Graduation: 2013 SARDAR VALLABHBHAI PATEL INSTITUTE OF VASAD Gujarat 388306
Ahmedabad, GJ
(Exam City 3)
Payment Details
Enclosure Checklist
Eligibility Certificate copy Stamped Bank Challan: GATE copy
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 2014 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 2014. 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 2014 score/marks is liable to be cancelled.
Digital Fingerprint:
7eef4de38a31c4f88ba43c03325e4eba
Date: ....../....../.........