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1AL
To
GATE 2013
Chairman GATE Indian Institute of Science, Bangalore Bengaluru, 560012
240 R 459 Y
94406 31321
(Mobile No.)
Cut Here
Note: Application ID - 240 R 459 Y. You should preserve this number for further correspondence.
Zone/Scrutiny Code
1AL
240 R 459 Y
(Full Name of Applicant)
4.5 cm x 3.5 cm
(Application ID)
04 Aug 1991
(D.O.B)
Female
(Name of Parent)
OBC-NC
Indian National
Communication Address
2-1-115 Ashok nagar Manuguru khammam Andhra Pradesh, 507117 India
Hyderabad, AP
(Exam City 1)
Secunderabad, AP
(Exam City 2) Scribe Assistance Required:
No
Qualification Details
B.Tech Civil/Environmental/Structural/Construction Engg. Graduated: Yes, Year of Graduation: 2012 Vignans Engineering College Guntur Andhra Pradesh, 522213
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Eligibility Certificate
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: ....../....../............