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    Instructions and Application Form For GATE 2012

    Uploaded by

    Uttam Ghosh
    1) The document provides instructions for candidates applying to GATE 2012. It details the application process and lists required documents. 2) Candidates must fill out and submit the application form along with documents like photo, fee payment receipt, and degree certificates. 3) The completed form and documents must be sealed and sent by speed post to the respective GATE zonal office by the deadline of October 24, 2011.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Instructions and Application Form For GATE 2012

    Uploaded by

    Uttam Ghosh
    26 views5 pages
    1) The document provides instructions for candidates applying to GATE 2012. It details the application process and lists required documents. 2) Candidates must fill out and submit the application form along with documents like photo, fee payment receipt, and degree certificates. 3) The completed form and documents must be sealed and sent by speed post to the respective GATE zonal office by the deadline of October 24, 2011.

    Original Title

    GATE2012_6023918

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    © Attribution Non-Commercial (BY-NC)

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    1) The document provides instructions for candidates applying to GATE 2012. It details the application process and lists required documents. 2) Candidates must fill out and submit the application form along with documents like photo, fee payment receipt, and degree certificates. 3) The completed form and documents must be sealed and sent by speed post to the respective GATE zonal office by the deadline of October 24, 2011.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    26 views5 pages

    Instructions and Application Form For GATE 2012

    Uploaded by

    Uttam Ghosh
    1) The document provides instructions for candidates applying to GATE 2012. It details the application process and lists required documents. 2) Candidates must fill out and submit the application form along with documents like photo, fee payment receipt, and degree certificates. 3) The completed form and documents must be sealed and sent by speed post to the respective GATE zonal office by the deadline of October 24, 2011.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 5

    Instructions and Application Form for GATE 2012

    Instructions for the Candidate:


    1. 2. Your Login ID is UTTA1001. Remember your password and do not disclose it to anyone. There are 5 pages in this pdf file. These pages should be printed on A4 size white sheets using a laser/ink jet printer. Page - 1: Instructions for the candidate to be retained by the candidate. Page - 2 : Application Form (GATE Copy). a. Paste your recent color photo (3.5cm x 3.5cm) in the designated place. Before pasting, please write your name and application number on the backside of the photo with black ball point pen. b. Sign at the designated place. Page - 3 : Application Form (Candidate copy) to be retained by the candidate. Page - 4 : Address page to be pasted on a 10 inch X 12 inch size laminated envelope. Page - 5 : Bank challan in triplicate. Take it to any Indian Bank branch and pay the application fee plus the bank service charge. The Bank will retain its copy and will return the remaining two copies to you. Out of these two copies, retain the Candidate's copy with you and attach the GATE copy with the Application Form. Without folding, insert the completed Application Form (GATE copy) and attested copies of all the application documents (SC/ST/PD certificate, copy of degree certificate etc.) into a 10 inch X 12 inch laminated envelope and send by Speed Post (preferably) or by Registered Post using the address printed on page-4 so as to reach the respective Zonal GATE office on or before 24th October 2011. Application sent through courier will not be accepted.

    3. 4.

    5. 6. 7.

    8.

    Put List of Documents to be attached with the Application Form:


    1. 2. 3. 4. 5. 6. Application Form (GATE Copy) Bank Challan (GATE Copy) Self Attested Copy of SC/ST/PD certificate (if applicable) Self Attested Copy of affidavit for change of name (if applicable) Self Attested Copy of the degree certificate if the year of qualifying degree is 2011 or earlier. If the year of qualifying degree is 2012 or later, a certificate signed by the principal of the college clearly indicating the year of qualifying degree (format available on GATE website). Candiates with backlog: copy of final semester/year marks sheet or course completion certificate or a letter from principal.

    7.

    ____________End of Instructions____________

    APPLICATION NO. 6023918

    GATE COPY

    GATE 2012 APPLICATION FORM


    Zone: IIT Kharagpur
    1. Name of the Candidate as in the 10th Class Certificate 2. Date of Birth (DD/MM/YYYY) 3. Gender

    Payment Mode: Bank Challan (Indian Bank)


    UTTAM GHOSH 10/01/1990 MALE 9. Choice of GATE Paper 10. E-mail Address

    Fee: Rs. 1000


    Chemistry [email protected]

    4. Nationality 5. Category 6. Person with Disability (PD)

    INDIAN General No

    11. Address for Correspondence VILL- NAGARUKHRA P.O- NAGARUKHRA P.S- HARINGHATA DIST- NADIA 12. PINCODE of Address for 741257 Correspondence 13. Year of Degree 14. Discipline 15. Name of Parent 2012 Chemistry GOURANGA GHOSH West Bengal

    7. Qualifying Degree

    M.Sc./M.C.A./M.A.

    16. State/Union Territory of Permanent Residence

    8. Choice of Examination City1 Choice of Examination City2

    611 - Kolkata 405 - Durgapur

    17. Mobile / Landline No.

    09477134592

    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

    611CY6023918

    Send this form along with the necessary documents to IIT Kharagpur.

    APPLICATION NO. 6023918

    CANDIDATE COPY

    GATE 2012 APPLICATION FORM


    Zone: IIT Kharagpur
    1. Name of the Candidate as in the 10th Class Certificate 2. Date of Birth (DD/MM/YYYY) 3. Gender

    Payment Mode: Bank Challan (Indian Bank)


    UTTAM GHOSH 10/01/1990 MALE 9. Choice of GATE Paper 10. E-mail Address

    Fee: Rs. 1000


    Chemistry [email protected]

    4. Nationality 5. Category 6. Person with Disability (PD)

    INDIAN General No

    11. Address for Correspondence VILL- NAGARUKHRA P.O- NAGARUKHRA P.S- HARINGHATA DIST- NADIA 12. PINCODE of Address for 741257 Correspondence 13. Year of Degree 14. Discipline 15. Name of Parent 2012 Chemistry GOURANGA GHOSH West Bengal

    7. Qualifying Degree

    M.Sc./M.C.A./M.A.

    16. State/Union Territory of Permanent Residence

    8. Choice of Examination City1 Choice of Examination City2

    611 - Kolkata 405 - Durgapur

    17. Mobile / Landline No.

    09477134592

    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

    611CY6023918

    Retain this copy with you for future reference.

    BY SPEED / REGISTERED POST (Please do not Courier) GATE 2012 Application Form

    To Chairman, GATE Indian Institute of Technology Kharagpur Kharagpur - 721302

    611CY6023918
    Do not tamper with the bar code. For GATE official use.

    From
    UTTAM GHOSH (APPLNO : 6023918) VILL- NAGARUKHRA P.O- NAGARUKHRA P.S- HARINGHATA DIST- NADIA 741257

    PAY IN SLIP

    BANK COPY

    PAY IN SLIP

    GATE COPY PAY IN SLIP

    CANDIDATE COPY

    APPLICATION FEE PAYABLE AT ALL BRANCHES OF INDIAN BANK Paid into the credit of IIT DELHI GATE 2012 (Challan) A/C no 971937016 , HAUZ KHAS BRANCH NEW DELHI, BRANCH CODE : 1104
    Name of the Candidate : UTTAM GHOSH

    APPLICATION FEE PAYABLE AT ALL BRANCHES OF INDIAN BANK Paid into the credit of IIT DELHI GATE 2012 (Challan) A/C no 971937016, HAUZ KHAS BRANCH NEW DELHI, BRANCH CODE : 1104
    Name of the Candidate : UTTAM GHOSH

    APPLICATION FEE PAYABLE AT ALL BRANCHES OF INDIAN BANK Paid into the credit of IIT DELHI GATE 2012 (Challan) A/C no 971937016, HAUZ KHAS BRANCH NEW DELHI, BRANCH CODE : 1104
    Name of the Candidate : UTTAM GHOSH

    Address for Correspondence :

    VILL- NAGARUKHRA P.O- NAGARUKHRA P.S Address for Correspondence : - HARINGHATA DIST- NADIA - 741257

    VILL- NAGARUKHRA P.O- NAGARUKHRA P.S Address for Correspondence : - HARINGHATA DIST- NADIA - 741257

    VILL- NAGARUKHRA P.O- NAGARUKHRA P.S - HARINGHATA DIST- NADIA - 741257

    Date of Birth : Mobile / Landline No : E-mail Address :

    10/01/1990 09477134592 [email protected]

    Date of Birth : Mobile / Landline No : E-mail Address :

    10/01/1990 09477134592 [email protected]

    Date of Birth : Mobile / Landline No : E-mail Address :

    10/01/1990 09477134592 [email protected]

    Head : Application Fees : Bank's Charges : Total * : Amount in words : Name of the Receiving Branch : Signature of the candidate : FOR BANKS USE MUP Ref. No: GATE Application Form No. : Branch Code : MU0003145181 Journal No: Signature of cashier : Date :

    Amount Rs. 1000.00 Rs. 25.00 Rs. 1025.00

    Head : Application Fees : Bank's Charges : Total * :

    Amount Rs. 1000.00 Rs. 25.00 Rs. 1025.00 Rupees One thousand and Twenty Five Only. (*Inclusive of Bank Charges)

    Head : Application Fees : Bank's Charges : Total * : Amount in words : Name of the Receiving Branch : Signature of the candidate : FOR BANKS USE MUP Ref. No: GATE Application Form No. : Branch Code : MU0003145181 Journal No: Signature of cashier : Date :

    Amount Rs. 1000.00 Rs. 25.00 Rs. 1025.00 Rupees One thousand and Twenty Five Only. (*Inclusive of Bank Charges)

    Rupees One thousand and Twenty Five Only. Amount in words : (*Inclusive of Bank Charges) Name of the Receiving Branch :

    Signature of the candidate : FOR BANKS USE MUP Ref. No: GATE Application Form No. : Branch Code : MU0003145181 Journal No: Signature of cashier : Date :

    6023918

    6023918

    6023918

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