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2ND
To
GATE 2013
Chairman GATE Indian Institute of Technology Bombay Powai, Mumbai, 400076
244 F 873 W
90967 08602
(Mobile No.)
Cut Here
Note: Application ID - 244 F 873 W. You should preserve this number for further correspondence.
Zone/Scrutiny Code
2ND
244 F 873 W
(Full Name of Applicant)
4.5 cm x 3.5 cm
(Application ID)
01 Mar 1991
(D.O.B)
Male
Chandrakant
(Name of Parent)
GEN
Indian National
Communication Address
At Yelegaon Post Kandalgaon Tal South Solapur Dist Solapur Solapur Maharashtra, 413221 India
Navi Mumbai, MH
(Exam City 1)
Mumbai(Central Line), MH
(Exam City 2) Scribe Assistance Required:
No
Qualification Details
B.E. Electronics/Comm./Telecomm Engg. Graduated: Yes, Year of Graduation: 2012 BIGCE, Solapur Solapur Maharashtra, 413255
Enclosure Checklist
Eligibility Certificate copy
Payment Details
Online
Rs. 1200.00
MSBI2821011960 02/10/2012
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: ....../....../............