Instructions and Application Form For GATE 2012
Instructions and Application Form For GATE 2012
Instructions and Application Form For GATE 2012
3. 4.
5. 6. 7.
8.
7.
____________End of Instructions____________
GATE COPY
INDIAN General No
11. Address for Correspondence SHITAL GORAMBEKAR SHEELA BUNGLOW,SHIKSHAK COLONY A/P,TAL-PALUS DIST-SANGLI 12. PINCODE of Address for 416310 Correspondence 13. Year of Degree 14. Discipline 15. Name of Parent 2012 Mechanical Engineering SHARAD RAGHUNATH GORAMBEKAR Maharashtra
7. Qualifying Degree
08308673267
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 contents of GATE 2012 website 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 2012. Further, if any such suppression or distortion of facts is found after appearing in the exam, any admission/degree acquired on the basis of GATE 2012 score is liable to be cancelled. Place : Date :
18. Signature
19. Photograph
Full Signature of the candidate using BLACK INK PEN only (do not sign in CAPITAL LETTERS)
3.5 cm x 3.5 cm
224ME2043674
Send this form along with the necessary documents to IIT Bombay.
CANDIDATE COPY
INDIAN General No
11. Address for Correspondence SHITAL GORAMBEKAR SHEELA BUNGLOW,SHIKSHAK COLONY A/P,TAL-PALUS DIST-SANGLI 12. PINCODE of Address for 416310 Correspondence 13. Year of Degree 14. Discipline 15. Name of Parent 2012 Mechanical Engineering SHARAD RAGHUNATH GORAMBEKAR Maharashtra
7. Qualifying Degree
08308673267
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 contents of GATE 2012 website 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 2012. Further, if any such suppression or distortion of facts is found after appearing in the exam, any admission/degree acquired on the basis of GATE 2012 score is liable to be cancelled. Place : Date :
18. Signature
19. Photograph
Full Signature of the candidate using BLACK INK PEN only (do not sign in CAPITAL LETTERS)
3.5 cm x 3.5 cm
224ME2043674
BY SPEED / REGISTERED POST (Please do not Courier) GATE 2012 Application Form
224ME2043674
Do not tamper with the bar code. For GATE official use.
From
GORAMBEKAR SHITAL SHARAD (APPLNO : 2043674) SHITAL GORAMBEKAR SHEELA BUNGLOW,SHIKSHAK COLONY A/P,TAL-PALUS DIST-SANGLI 416310
CASH VOUCHER
CANDIDATE COPY
Challan can be deposited minimum one day after the generation of challan.
Name of the Candidate : GORAMBEKAR SHITAL SHARAD Address for Correspondence :
Challan can be deposited minimum one day after the generation of challan.
Name of the Candidate : GORAMBEKAR SHITAL SHARAD
Challan can be deposited minimum one day after the generation of challan.
Name of the Candidate : GORAMBEKAR SHITAL SHARAD
S H E E L A Address for Correspondence : BUNGLOW,SHIKSHAK COLONY A/P,TALSHITAL GORAMBEKAR PALUS DIST-SANGLI - 416310
S H E E L A Address for Correspondence : BUNGLOW,SHIKSHAK COLONY A/P,TALSHITAL GORAMBEKAR PALUS DIST-SANGLI - 416310
SHITAL
GORAMBEKAR
SHEELA
08308673267 [email protected]
08308673267 [email protected]
08308673267 [email protected]
General Rs.1025/- * Rupees One thousand and Twenty Five Only. (*Application Fees Including Bank Charges)
General Rs.1025/- * Rupees One thousand and Twenty Five Only. (*Application Fees Including Bank Charges)
General Rs.1025/- * Rupees One thousand and Twenty Five Only. (*Application Fees Including Bank Charges)
JOURNAL NUMBER
JOURNAL NUMBER
JOURNAL NUMBER
Signature of the Candidate/Remitter For Receiving Branch use only 1. Please note to write the Journal Number in all the challans. 2. Please feed the Application No. in REG/ID/Ref No. Column.
Signature of the Candidate/Remitter For Receiving Branch use only 1. Please note to write the Journal Number in all the challans. 2. Please feed the Application No. in REG/ID/Ref No. Column.
Signature of the Candidate/Remitter For Receiving Branch use only 1. Please note to write the Journal Number in all the challans. 2. Please feed the Application No. in REG/ID/Ref No. Column.
SEAL / DATE
AUTHORISED SIGNATORY
SEAL / DATE
AUTHORISED SIGNATORY
SEAL / DATE
AUTHORISED SIGNATORY