Zone/Scrutiny GATE 2016

1GE B145K31
B145K31 (Enrolment ID)

Roshini Elsa Mathew

(Full Name of the Applicant)

26 May 1994 Female GEN No

(D.O.B) (Gender) (Category) (PD Status)

Indian National 9447958586 Mathew T V

(Parent's Mobile Number) (Name of the Parent)

Communication Address GATE Exam Details

Thekkethil House Vallamkulam east Thiruv GATE Paper Code
Amal Jyothi college of eng kanjirapally
Thiruvalla
Kerala 689541
94479 58586 (Mobile No.)
CE
(Civil Engineering)
roshinielsa09@gmail.com Kanjirappally , KL
(Exam City 1)

Qualification Details Kottayam , KL

(Exam City 2)
B.Tech
Civil/Civil & Environmental/Structural Engg./ Thiruvananthapuram, KL
(Exam City 3)
Graduated: No; Year of Graduation: 2016
AJCE Kanjirapally Zonal GATE Office Contact
Kanjirapally Chairperson GATE
Kerala 686518 Indian Institute of Science Bangalore
Bengaluru 560012
Payment Details
Online Rs. 750.00
Payment Ref. No.: CP29514321
24/09/2015

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. The
responsibility of following the GATE 2016 website and meeting various deadlines lies with me. 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 2016. Further, if any suppression or distortion of facts is found after appearing in the
exam, any admission/degree/benefit acquired on the basis of GATE 2016 score/marks is liable to be
cancelled.

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