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ONLINE Application for GATE 2011

Instructions for the Candidate:

1. Your Login ID is MANU1703. Remember your password and do not disclose it to anyone.
2. There are 5 Pages in this file. These pages should be printed on A4 sheets.
3. Page - 1: Instructions for the candidate to be retained by you carefully
4. Page - 2 : Application Form (GATE Copy)
a. Paste your recent color photo (3cm x 4cm) in designated place
b. Sign at designated places
5. Page - 3 : Application Form (CANDIDATE Copy) to be retained by you for your reference
6. Page - 5 : Bank challan in triplicate. Take it to any SBI branch and pay the fee. The Bank will retain a
copy with them and will return two copies to you. In those two copies, retain the Candidate's copy with
you and attach Institute's copy with Application Form

7. Page - 4 : Address slip to be pasted on the A4 size envelope
8. Insert completed Application Form (GATE Copy) and attested copies of all applicable documents
(SC/ST/PD Certificate, Affidavit for change of name) into A4 size envelope, without folding and send by
Speed Post (preferably) or by Registered Post to Chairman, GATE, IISc Bangalore

List of Documents to be sent to GATE IISc Bangalore:
1. Application Form (GATE Copy)
2. Bank Challan (Institute's Copy)
3. Attested Copy of SC/ST/PD Certificate (if applicable)
4. Attested Copy of affidavit for change of name (if applicable)

Page - 1

Photograph Paste a front facial high contrast recent 13./B. Place: Date: Full Signature of the Candidate (do not sign in capital letters) 12.(Tech. if any such suppression or distortion of facts is found after appearing in the exam. Person with Disability (PD) No Do You Require a Scribe? No 16. Phone / Mobile 08105765410 8.Sc.Mechanical Engineering 10. Discipline Production & Industrial Engg.)/B. KUVEMPUNAGAR 2.2 . Nationality INDIAN 14. Name of Parent S MOHAN 7.E. E-mail Address anusha. Gender FEMALE 4. 800/- 1./ B. Qualifying Degree B. 5. any admission/degree acquired on the basis of GATE 2011 score is liable to be cancelled. GATE IISc Bangalore COPY APPLICATION FORM FOR GATE 2011 Application No: 1158935 Payment Mode: Bank Challan (State Bank of India) Zone: IISc Bangalore Application Fee: Rs. In the event of suppression or distortion of any fact in my application form.Sc. State/Union Territory of Karnataka (Engg. I understand that I will be denied the opportunity to appear in GATE 2011. Name of the Candidate as in M ANUSHA 11. Permanent Residence 18.Tech. Year of Degree 2011 15.Arch. Choice of GATE Paper ME . Date of Birth (DD/MM/YYYY) 17/03/1990 MYSORE PINCODE 570009 3.com I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. Full Signature of the Candidate color photograph 1158935 using black ball point pen only 3cm x 4cm (do not sign in capital letters) without any signature or attestation Send this form along with the necessary documents to IISc Bangalore Page . PINCODE of Address 570009 Choice of Examination City2 103 . Choice of Examination City1 111 .)/B.gmohan@gmail. Address NO 10. Further.Bangalore for Correspondence 9.Mysore Number 19. Category General 6. 17.SRIKRISHNA BLOCK the 10th Class Certificate SARASWATHIPURAM POLICE QTRS.

Permanent Residence 18. Choice of GATE Paper ME . Full Signature of the Candidate color photograph 1158935 using black ball point pen only 3cm x 4cm (do not sign in capital letters) without any signature or attestation Retain this page for your reference Page .E. State/Union Territory of Karnataka (Engg. Category General 6. Further. KUVEMPUNAGAR 2.)/B.Tech. 800/- 1.Arch. any admission/degree acquired on the basis of GATE 2011 score is liable to be cancelled.(Tech. Choice of Examination City1 111 . Discipline Production & Industrial Engg./ B. Gender FEMALE 4. CANDIDATE COPY APPLICATION FORM FOR GATE 2011 Application No: 1158935 Payment Mode: Bank Challan (State Bank of India) Zone: IISc Bangalore Application Fee: Rs. In the event of suppression or distortion of any fact in my application form.gmohan@gmail. 5. 17./B.3 .com I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. PINCODE of Address 570009 Choice of Examination City2 103 . E-mail Address anusha. Qualifying Degree B. Year of Degree 2011 15.Mechanical Engineering 10. I understand that I will be denied the opportunity to appear in GATE 2011. Name of the Candidate as in M ANUSHA 11.Sc.Mysore Number 19. Nationality INDIAN 14. if any such suppression or distortion of facts is found after appearing in the exam.Sc. Person with Disability (PD) No Do You Require a Scribe? No 16.)/B. Phone / Mobile 08105765410 8.Bangalore for Correspondence 9. Date of Birth (DD/MM/YYYY) 17/03/1990 MYSORE PINCODE 570009 3. Place: Date: Full Signature of the Candidate (do not sign in capital letters) 12. Address NO 10. Name of Parent S MOHAN 7.SRIKRISHNA BLOCK the 10th Class Certificate SARASWATHIPURAM POLICE QTRS. Photograph Paste a front facial high contrast recent 13.

BY SPEED POST / REGISTERED POST GATE 2011 GATE PAPER CODE ME To EXAM CITY OF FIRST Chairman.SRIKRISHNA BLOCK APPLICATION NO SARASWATHIPURAM POLICE QTRS.4 . KUVEMPUNAGAR MYSORE 1 1 5 8 9 3 5 PINCODE 5 7 0 0 0 9 Page . GATE CHOICE 111 Indian Institute of Science Bangalore Bangalore From PINCODE 5 6 0 0 1 2 M ANUSHA NO 10.

Amount in words : Rupees eight hundred and thirty only.00 98353XXXXXX Bank's Charges Rs.gmohan@gmail. SEAL / DATE AUTHORISED SIGNATORY SEAL / DATE AUTHORISED SIGNATORY SEAL / DATE AUTHORISED SIGNATORY . in REG/ID/Ref No. Please note to write the Journal Number in all the challans.00 Total Rs.com Category : General Category : General Category : General Physically Disabled : No Physically Disabled : No Physically Disabled : No Head Amount Credit to Head Amount Credit to Head Amount Credit to Application Fees Rs.00 31372883605 Application Fees Rs. in REG/ID/Ref No.98353XXXXXX A/c No. Please note to write the Journal Number in all the challans. Please feed the Application No.00 98353XXXXXX Total Rs.570009 Date of Birth 17/03/1990 Date of Birth 17/03/1990 Date of Birth 17/03/1990 Mobile / Landline No: 08105765410 Mobile / Landline No: 08105765410 Mobile / Landline No: 08105765410 E-mail Address: anusha. ) GATE 2011 – Online Application Fee Payment GATE 2011 – Online Application Fee Payment GATE 2011 – Online Application Fee Payment GATE 2011 FEE COLLECTION A/C NO. 3. Please feed the Application No. KUVEMPUNAGAR MYSORE .30/.570009 KUVEMPUNAGAR MYSORE . 31372883605 Name of the Candidate M ANUSHA Name of the M ANUSHA Name of the M ANUSHA Present Address Present Address Present Address NO 10.CASH VOUCHER BANK'S COPY CASH VOUCHER INSTITUTE’S COPY CASH VOUCHER CANDIDATE'S COPY BRANCH (CODE NO.30/. Column 3.00 31372883605 Bank's Charges Rs. SARASWATHIPURAM POLICE QTRS.800. 830.00 98353XXXXXX Bank's Charges Rs. Please feed the Application No. Amount in words : Rupees eight hundred and thirty only.00 Amount in words : Rupees eight hundred and thirty only. 2.gmohan@gmail.30/. 800.to your Branch Commission 1. Please credit Rs.00 Total Rs. in REG/ID/Ref No. 31372883605 GATE 2011 FEE COLLECTION A/C NO. 830. and Name of the Candidate in the menu while posting.to your Branch Commission 1. Please credit Rs. ) BRANCH (CODE NO.98353XXXXXX 2. 30. 31372883605 GATE 2011 FEE COLLECTION A/C NO. 2. 830. 800. Please note to write the Journal Number in all the challans. Please credit Rs. and Name of the Candidate in the menu while posting.98353XXXXXX A/c No.SRIKRISHNA BLOCK NO 10. 30. ) BRANCH (CODE NO.gmohan@gmail. SARASWATHIPURAM POLICE QTRS. Signature of the Candidate/Remitter Signature of the Candidate/Remitter Signature of the Candidate/Remitter For Receiving Branch use only For Receiving Branch use only For Receiving Branch use only APPLICATION NUMBER JOURNAL NUMBER APPLICATION NUMBER JOURNAL NUMBER APPLICATION NUMBER JOURNAL NUMBER 1158935 1158935 1158935 1.SRIKRISHNA BLOCK SARASWATHIPURAM POLICE QTRS. 30.00 31372883605 Application Fees Rs. Column 3.570009 KUVEMPUNAGAR MYSORE .SRIKRISHNA BLOCK NO 10. Column and Name of the Candidate in the menu while posting.com E-mail Address: anusha.com E-mail Address: anusha.to your Branch Commission A/c No.