Application Form

Zone/Scrutiny Code

5OB T214D97

T214D97 (Enrollment ID)

MOHIT KUMAR
(Full Name of the Applicant)

08 Sep 2000 Male OBC-NCL

(D.O.B) (Gender) (Category)

Indian +91-8726788975 BHAGWAN DAS

National (Parent/Guardian's Mobile Number) (Parent/Guardian's Name)

Communication Address GATE Exam Details

Ambedkar Nagar Ward No.4 Pipraich Gorakhpur GATE Paper Code
Pipraich
Pipraich
Pipraich,Gorakhpur
Uttar Pradesh 273152
EC
+91-9807842885 (Mobile No.) (Electronics and
Communication
mohitkumar9807842@gmail.com
Engineering)

Exam City 1 : Jhansi (UP)

Qualification Details Exam City 2 : Gwalior (MP)
B. Tech Exam City 3 : Bhopal (MP)
Electronics & Communication.
Graduated: No; Year of Graduation: 2025 Zonal GATE Office Contact
BUNDELKHAND UNIVERSITY GATE Office
Jhansi Indian Institute of Technology Kanpur
Uttar Pradesh 284128
Kanpur 208016
gate@iitk.ac.in, 0512-2596962

DECLARATION
I confirm that I fulfil the eligibility criteria to appear for the Graduate Aptitude Test in Engineering (GATE 2024) examination. I have read the Information
Brochure and filled up the GATE 2024 Application Form myself. I agree to strictly comply with the code of conduct for GATE 2024 examination as detailed in
the Information Brochure. I confirm that the information provided by me in this form is correct. I also confirm that I am NOT filling more than one Application
Form for myself.
If any of the information provided by me is found to be incorrect later, I understand that my candidature for GATE 2024 may be cancelled, before, during, or
after the examination, including the time after generation of my GATE 2024 Score Card. Further, I understand that I may be liable for legal action for
providing false information. GATE 2024 Examination Body’s decision will be final and legally binding on me.
I also understand that GATE is NOT an admission ensuring examination, and qualifying in GATE examination does NOT guarantee admission, scholarship,
or a job. GATE 2024 Examination Body shall NOT be liable for any legal obligations arising out of this matter.
I am aware that the data provided by me during the application process as well as my GATE results may be shared for admission or recruitment purposes.

e-Signature : null
Digital Fingerprint : 6a6542bc8bd2d80a1687098e9dccb143

PROVISIONAL APPLICATION SUBJECT TO PAYMENT