Professional Documents
Culture Documents
Zone/Scrutiny Code
5FF
To
GATE 2013
Chairman GATE Indian Institute of Technology Kanpur Kanpur, 208016
132 E 863 H
81094 80989
(Mobile No.)
Cut Here
Note: Application ID - 132 E 863 H. You should preserve this number for further correspondence.
Zone/Scrutiny Code
5FF
132 E 863 H
4.5 cm x 3.5 cm
(Application ID)
Neelam Singh
(Full Name of Applicant)
132 E 863 H
28 Apr 1989
(D.O.B)
Female
(Name of Parent)
GEN
Indian National
Yashwant Singh
Communication Address
01 AVANTIKA AVENUE PHASE 3 CHURCH ROAD BERKHEDA BHEL BHOPAL Madhya Pradesh, 462021 India
Bhopal, MP
(Exam City 1)
Indore, MP
(Exam City 2) Scribe Assistance Required:
No
Qualification Details
B.E. Information Science/Technology Graduated: Yes, Year of Graduation: 2011 NIIST BHOPAL BHOPAL Madhya Pradesh, 462021
Enclosure Checklist
Eligibility Certificate copy
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: ....../....../............