Professional Documents
Culture Documents
4ND
To
GATE 2013
Chairman GATE Indian Institute of Technology Guwahati Guwahati, 781039
240 A 728 G
97067 10106
(Mobile No.)
Cut Here
Note: Application ID - 240 A 728 G. You should preserve this number for further correspondence.
Zone/Scrutiny Code
4ND
240 A 728 G
4.5 cm x 3.5 cm
(Application ID)
Mayur Borah
(Full Name of Applicant)
240 A 728 G
18 Jun 1986
(D.O.B)
Male
Ajit Borah
(Name of Parent)
OBC-NC
Indian National
Communication Address
JOGDUAR GAYENGAON PO-BONAI,VIA-JHANJI JORHAT Assam, 785683 India
Jorhat, AS
(Exam City 1)
Guwahati, AS
(Exam City 2) Scribe Assistance Required:
No
Qualification Details
B.Tech Information Science/Technology Graduated: Yes, Year of Graduation: 2012 School Of Technology,North Eastern Hill University Shillong Meghalaya, 793022
Enclosure Checklist
Eligibility Certificate copy
Payment Details
Online
Rs. 1200.00
MSBI2819576640 30/09/2012
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: ....../....../............