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    Instructions and Application Form For GATE 2012

    Uploaded by

    Divya Verma
    The document provides instructions for candidates applying to GATE 2012. It outlines the application process and documents required. The key points are: 1. Candidates must fill out and submit the application form along with documents including a bank challan, photo, and copies of certificates by October 24, 2011. 2. The application includes personal details, exam preferences, and a declaration agreeing to terms. 3. Candidates must pay Rs. 1000, take the bank receipt, and attach it to their application to be sent by speed post to the respective GATE office.

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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

    Divya Verma
    92 views5 pages
    The document provides instructions for candidates applying to GATE 2012. It outlines the application process and documents required. The key points are: 1. Candidates must fill out and submit the application form along with documents including a bank challan, photo, and copies of certificates by October 24, 2011. 2. The application includes personal details, exam preferences, and a declaration agreeing to terms. 3. Candidates must pay Rs. 1000, take the bank receipt, and attach it to their application to be sent by speed post to the respective GATE office.

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    GATE2012_8002897

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    © Attribution Non-Commercial (BY-NC)

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    The document provides instructions for candidates applying to GATE 2012. It outlines the application process and documents required. The key points are: 1. Candidates must fill out and submit the application form along with documents including a bank challan, photo, and copies of certificates by October 24, 2011. 2. The application includes personal details, exam preferences, and a declaration agreeing to terms. 3. Candidates must pay Rs. 1000, take the bank receipt, and attach it to their application to be sent by speed post to the respective GATE office.

    Copyright:

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

    Instructions and Application Form For GATE 2012

    Uploaded by

    Divya Verma
    The document provides instructions for candidates applying to GATE 2012. It outlines the application process and documents required. The key points are: 1. Candidates must fill out and submit the application form along with documents including a bank challan, photo, and copies of certificates by October 24, 2011. 2. The application includes personal details, exam preferences, and a declaration agreeing to terms. 3. Candidates must pay Rs. 1000, take the bank receipt, and attach it to their application to be sent by speed post to the respective GATE office.

    Copyright:

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    Download as PDF, TXT or read online from Scribd
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    Instructions and Application Form for GATE 2012

    Instructions for the Candidate:


    1. 2. Your Login ID is KRIS0110. 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. 5. 6. 7. 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 SBI 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.

    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).

    ____________End of Instructions____________

    APPLICATION NO. 8002897

    GATE COPY

    GATE 2012 APPLICATION FORM


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

    Payment Mode: Bank Challan (SBI)


    KRISHAN GOPAL SHAKYA 01/10/1989 MALE 9. Choice of GATE Paper 10. E-mail Address

    Fee: Rs. 1000


    Electrical Engineering kgs143@gmail.com

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

    INDIAN OBC(Non-Creamy Layer) No

    11. Address for Correspondence ASHOK NAGAR STREET NO. 3 BEHIND LALWANI NURSING HOME NIDHOLI ROAD ETAH U.P 12. PINCODE of Address for 207001 Correspondence 13. Year of Degree 14. Discipline 15. Name of Parent 2012 Electrical Engg/Electrical and Electronics Engg./Power Engg MADAN LAL SHAKYA Uttar Pradesh

    7. Qualifying Degree

    B.E./B.Tech./ B.Sc. (Engg.)/B.Sc.(Tech.)/B.Arch.

    16. State/Union Territory of Permanent Residence

    8. Choice of Examination City1 Choice of Examination City2

    806 - Ghaziabad 818 - Noida

    17. Mobile / Landline No.

    09958362122

    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

    806EE8002897

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

    APPLICATION NO. 8002897

    CANDIDATE COPY

    GATE 2012 APPLICATION FORM


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

    Payment Mode: Bank Challan (SBI)


    KRISHAN GOPAL SHAKYA 01/10/1989 MALE 9. Choice of GATE Paper 10. E-mail Address

    Fee: Rs. 1000


    Electrical Engineering kgs143@gmail.com

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

    INDIAN OBC(Non-Creamy Layer) No

    11. Address for Correspondence ASHOK NAGAR STREET NO. 3 BEHIND LALWANI NURSING HOME NIDHOLI ROAD ETAH U.P 12. PINCODE of Address for 207001 Correspondence 13. Year of Degree 14. Discipline 15. Name of Parent 2012 Electrical Engg/Electrical and Electronics Engg./Power Engg MADAN LAL SHAKYA Uttar Pradesh

    7. Qualifying Degree

    B.E./B.Tech./ B.Sc. (Engg.)/B.Sc.(Tech.)/B.Arch.

    16. State/Union Territory of Permanent Residence

    8. Choice of Examination City1 Choice of Examination City2

    806 - Ghaziabad 818 - Noida

    17. Mobile / Landline No.

    09958362122

    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

    806EE8002897

    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 Roorkee Roorkee - 247667

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

    From
    KRISHAN GOPAL SHAKYA (APPLNO : 8002897) ASHOK NAGAR STREET NO. 3 BEHIND LALWANI NURSING HOME NIDHOLI ROAD ETAH U.P 207001

    CASH VOUCHER

    BANK COPY CASH VOUCHER

    GATE COPY CASH VOUCHER

    CANDIDATE COPY

    Last date for acceptance of challan in bank : 24 October 2011.


    CASH CAN BE TENDERED AT ANY SBI BRANCH GATE 2012 Application Fee Payment Challan
    Use CBS Screen No. : FEE Type : Registration ID / Ref No. : Date of Birth : 8888 16 8002897 01/10/1989

    Last date for acceptance of challan in bank : 24 October 2011.


    CASH CAN BE TENDERED AT ANY SBI BRANCH GATE 2012 Application Fee Payment Challan
    Use CBS Screen No. : FEE Type : Registration ID / Ref No. : Date of Birth : 8888 16 8002897 01/10/1989

    Last date for acceptance of challan in bank : 24 October 2011.


    CASH CAN BE TENDERED AT ANY SBI BRANCH GATE 2012 Application Fee Payment Challan
    Use CBS Screen No. : FEE Type : Registration ID / Ref No. : Date of Birth : 8888 16 8002897 01/10/1989

    Challan can be deposited minimum one day after the generation of challan.
    Name of the Candidate : KRISHAN GOPAL SHAKYA Address for Correspondence :

    Challan can be deposited minimum one day after the generation of challan.
    Name of the Candidate : KRISHAN GOPAL SHAKYA

    Challan can be deposited minimum one day after the generation of challan.
    Name of the Candidate : KRISHAN GOPAL SHAKYA

    ASHOK NAGAR STREET NO. 3 BEHIND Address for Correspondence : LALWANI NURSING HOME NIDHOLI ROAD ETAH U.P - 207001

    ASHOK NAGAR STREET NO. 3 BEHIND Address for Correspondence : LALWANI NURSING HOME NIDHOLI ROAD ETAH U.P - 207001

    ASHOK NAGAR STREET NO. 3 BEHIND LALWANI NURSING HOME NIDHOLI ROAD ETAH U.P - 207001

    Mobile / Landline No: E Mail ID :

    09958362122 kgs143@gmail.com

    Mobile / Landline No: E Mail ID :

    09958362122 kgs143@gmail.com

    Mobile / Landline No: E Mail ID :

    09958362122 kgs143@gmail.com

    Category : Amount : Amount in words :

    OBC(Non-Creamy Layer) Rs.1025/- * Rupees One thousand and Twenty Five Only. (*Application Fees Including Bank Charges)

    Category : Amount : Amount in words :

    OBC(Non-Creamy Layer) Rs.1025/- * Rupees One thousand and Twenty Five Only. (*Application Fees Including Bank Charges)

    Category : Amount : Amount in words :

    OBC(Non-Creamy Layer) Rs.1025/- * Rupees One thousand and Twenty Five Only. (*Application Fees Including Bank Charges)

    JOURNAL NUMBER

    JOURNAL NUMBER

    JOURNAL NUMBER

    Signature of the Candidate/Remitter For Receiving Branch use only 1. Please note to write the Journal Number in all the challans. 2. Please feed the Application No. in REG/ID/Ref No. Column.

    Signature of the Candidate/Remitter For Receiving Branch use only 1. Please note to write the Journal Number in all the challans. 2. Please feed the Application No. in REG/ID/Ref No. Column.

    Signature of the Candidate/Remitter For Receiving Branch use only 1. Please note to write the Journal Number in all the challans. 2. Please feed the Application No. in REG/ID/Ref No. Column.

    SEAL / DATE

    AUTHORISED SIGNATORY

    SEAL / DATE

    AUTHORISED SIGNATORY

    SEAL / DATE

    AUTHORISED SIGNATORY

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