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    Online Application Form For Gate 2009: Application Number Demand Draft Details

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    kumarsanjeev.net9511
    Sanjeev Kumar has submitted an online application form for GATE 2009. He is applying from Jaipur, Rajasthan with examination city preferences of Jaipur and New Delhi. He has included a photograph, signature, and demand draft details in the application. By submitting the form, Sanjeev agrees to the terms and conditions in the Information Brochure and understands that any suppression or distortion of facts could lead to denial of opportunity to appear in GATE 2009 or cancellation of admission/degree.

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    Online Application Form For Gate 2009: Application Number Demand Draft Details

    Uploaded by

    kumarsanjeev.net9511
    10 views1 page
    Sanjeev Kumar has submitted an online application form for GATE 2009. He is applying from Jaipur, Rajasthan with examination city preferences of Jaipur and New Delhi. He has included a photograph, signature, and demand draft details in the application. By submitting the form, Sanjeev agrees to the terms and conditions in the Information Brochure and understands that any suppression or distortion of facts could lead to denial of opportunity to appear in GATE 2009 or cancellation of admission/degree.

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    Sanjeev Gate

    Original Title

    Sanjeev Gate

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    Sanjeev Kumar has submitted an online application form for GATE 2009. He is applying from Jaipur, Rajasthan with examination city preferences of Jaipur and New Delhi. He has included a photograph, signature, and demand draft details in the application. By submitting the form, Sanjeev agrees to the terms and conditions in the Information Brochure and understands that any suppression or distortion of facts could lead to denial of opportunity to appear in GATE 2009 or cancellation of admission/degree.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    10 views1 page

    Online Application Form For Gate 2009: Application Number Demand Draft Details

    Uploaded by

    kumarsanjeev.net9511
    Sanjeev Kumar has submitted an online application form for GATE 2009. He is applying from Jaipur, Rajasthan with examination city preferences of Jaipur and New Delhi. He has included a photograph, signature, and demand draft details in the application. By submitting the form, Sanjeev agrees to the terms and conditions in the Information Brochure and understands that any suppression or distortion of facts could lead to denial of opportunity to appear in GATE 2009 or cancellation of admission/degree.

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    SUBMITTED ON : gate.iitd.ac.

    in

    ORGANISING INSTITUTE: INDIAN INSTITUTE OF TECHNOLOGY ROORKEE

    ONLINE APPLICATION FORM FOR GATE 2009


    COMPLETE MAILING ADDRESS INCLUDING NAME PHOTOGRAPH PASTE (DO NOT STAPLE) A RECENT FRONT FACIAL HIGH CONTRAST PHOTOGRAPH OF SIZE 3 CM X 4 CM. Photograph must not be larger than this

    NAME:

    SANJEEV KUMAR 31/61/01, Varun Path, Mansarover, Jaipur (Rajasthan)

    ADDRESS:

    PIN CODE:

    302020

    box or else the application is liable to be rejected. Do not get the photograph attested

    Email Address: kumarsanjeev.net@gmail.com

    361816

    FULL SIGNATURE WITH BLACK BALLPOINT PEN

    INFORMATION TO THE CANDIDATE: On the printed form, paste your PHOTOGRAPH and SIGN at the two specified places. Keep a photcopy of the form and the demand draft. Send the compeleted form along with the Demand Draft, a copy of the SC/ST/OBC (Non Creamy Layer)/PD certificate, (if applicable) to the CHAIRMAN, GATE, of the corrsponding zone (website of which has been used) by Speed/Registered Post.

    APPLICATION NUMBER
    NAME OF THE CANDIDATE EXAMINATION CITY CODE (1st Choice) EXAMINATION CITY CODE (2nd Choice)

    : 361816 : SANJEEV KUMAR : Jaipur (308) : New Delhi (313)

    DEMAND DRAFT DETAILS


    BANK NAME BANK ID(MICRO NO) : STATE BANK OF INDIA : 000002000

    DEMAND DRAFT NUMBER : 733973 AMOUNT : Rs. 900.00 Only

    DATE OF ONLINE SUBMISSION (dd/mm/yy) : 16/10/08

    DATE OF ISSUE (dd/mm/yy) : 16/10/08

    OTHER DETAILS

    :
    : JAGDISH PURVEY : 09/10/80 : Male : Indian : NO :G : Rajasthan (RJ) GATE PAPER CODE QUALIFYING DEGREE QUALIFYING YEAR DISCIPLINE CODE COLLEGE CODE PIN CODE OF COLLEGE MOBILE/LANDLINE PHONE : : : : : : : EC E 2005 18 HR027 123506 09352841589

    NAME OF PARENT DATE OF BIRTH (dd/mm/yy) GENDER NATIONALITY PERSON WITH DISABILITY CATEGORY STATE/UT OF PERMANENT ADDRESS

    TICK THE CHECK LIST


    Pasted a recent high contrast photograph? Signed(with black ballpoint pen) in the box? Signed (with black ballpoint pen) the declaration? Kept a photocopy of the filled Printed Form?

    LIST OF ATTACHMENTS (TICK APPROPRIATE BOX)


    Demand Draft mentioned in Application. Attested copy of SC/ST/PD/OBC(non creamy layer) Certificate(if appplicable). In case of PD Candidate, requested for Amanuensis(if applicable)? Attested copy of the affidavit for Change of Name/Surname(if applicable).

    DECLARATION BY THE CANDIDATE :


    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 supperssion or distortion of any fact in my Application Form. I understand that I will be denied the opportunity to appear in GATE 2009. Further, if any such supperssion or distortion of facts is discovered after appearing in the examination, any admission/degree acquired on the basis of GATE 2009 score is liable for cancellation.

    Place:_________________ Date:__________________
    FULL SIGNATURE OF THE CANDIDATE

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