Professional Documents
Culture Documents
Zone/Scrutiny Code
2CP
To
GATE 2013
Chairman GATE Indian Institute of Technology Bombay Powai, Mumbai, 400076
124 R 085 S
(Mobile No.)
94279 43363
Cut Here
Note: Application ID - 124 R 085 S. You should preserve this number for further correspondence.
Zone/Scrutiny Code
2CP
124 R 085 S
(Full Name of Applicant)
4.5 cm x 3.5 cm
(Application ID)
18 Nov 1991
(D.O.B)
Male
(Name of Parent)
OBC-NC
Indian National
Communication Address
A-33/5 K.P.T Colony Vadinar-361010 Dist-Jamnagar Gujarat, 361010 India
Ahmedabad, GJ
(Exam City 1)
Vadodara, GJ
(Exam City 2) Scribe Assistance Required:
No
Qualification Details
B.E. Mechanical Engg. Graduated: No, Year of Graduation: 2013 Viswkarma Goernment Engineering College , Gandhinagar Gujarat, 382424
Enclosure Checklist
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: ....../....../............
Principal Certificate
(For use as the eligibility certificate only for final year or backlog applicants)
This is to certify that Kanjariya Jagdish Ranamal is a student enrolled in Viswkarma Goernment Engineering College , Chandkheda, Gandhinagar, Gandhinagar. He is a student of the final year of B.E.. He appeared in the final semester/year exam of the above degree, but has a backlog to be cleared from an earlier semester/year, and therefore cannot produce a course completion certificate.
Date:
Seal