shafaque
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1. This print out should contain the following pages.
(a) This page: Address Slip and Instructions.(b) Application form, filled with the information you provided online.(c) Bank Challan in Triplicate (available as a separate file for download from the
GATE Online Application Interface), if you have chosen Offline Challan Payment (Not applicable for female candidates).
2. On the GATE copy of the Application Form, paste a 4.5cm x 3.5cm printed copy of the SAME colorphotograph you uploaded online.(a) Use good quality glue to ensure that the photograph does not separate from the application.(b) Do not pin, stapple, sign, or attest the photograph.
3. Read the declaration and put your signature in the box next to it.
4. If you are in the final year or you have a backlog after appearing for the final year exam, you must get yourPrincipals or HODs sign and seal in the last portion of the application form. Submit the whole formto the Principals office without cutting it.
5. If you have opted for Challan payment, wait for 48 hours after your online submission to visit the banksbranch. You can visit any branch of the bank printed on your challan.
6. The bank teller will verify the details printed on the challan with the data available on their computer andthen accept the payment. The bank will retain one copy and give you back the remaining copies: one ofwhich you have to send along with the printed application form and the other is for your reference.
7. Mailing Documents to GATE office.(a) Cut the Address Slip and paste it onto an A4 sized envelope (Do not fill address by hand or tamper the
address slip).(b) Collect the supporting documents shown under Enclosure Checklist in the application form (if you
have uploaded the soft copy of the documents online, you need not send a hard copy). Mark the checklist boxes.
(c) Do NOT FOLD the application form and Do NOT STAPLE or pin the documents to the form.(d) Send the packet by Speed Post (preferably) or by Registered Post to the address mentioned. The
application packet should REACH the respective GATE office on or before Monday, 8 October 2012.
850
nagpur
bhaldurpura
Instructions to the Applicant (GATE 2013)
Zone/Scrutiny Code
2FFBy Registered Post/Speed Post Only
(Mobile No.)
Indian Institute of Technology Bombay
GATE 2013
Maharashtra, 440018
To
Shafaque Sheikh
Chairman GATE
95799 93730
178 J 436 J
Powai, Mumbai, 400076
Cut Here
mohd ali chowkh
From
Note: Application ID - 178 J 436 J. You should preserve this number for further correspondence.
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(Application ID)78 J 436 J
GATE 2013Zone/Scrutiny Code
2FF
D.O.B)
Scribe Assistance Required:
Qualification Details
(Exam City 1)
Shafaque SheikhFull Name of Applicant)
23 Mar 1991 Female
ndian National
GEN
No
B.E.
Nagpur, MH
Amravati, MH
EC
Mohd Shakir(Name of Parent)
Maharashtra, 440018
Maharashtra, 440001
mohd ali chowkh
anjuman college of engineering and technology
(GATE Paper code)
Communication Address
Graduated: No, Year of Graduation: 2013
Electronics/Comm./Telecomm Engg.
95799 93730
hereby declare that all the particulars stated in this application form are true to the best of my knowledgend belief. I have read the Information Brochure and I shall abide by the terms and conditions therein. In thevent of suppression or distortion of any fact in my application form, I understand that I will be denied the
pportunity to appear in GATE 2013. Further, if any suppression or distortion of facts is found after appearingn the exam, any admission/degree acquired on the basis of GATE 2013 score is liable to be cancelled.
Digital Fingerprint:
nagpur
bhaldurpura
She appeared in the final semester/year exam of the above degree, but has a backlog to be clearedfrom an earlier semester/year, and therefore cannot produce a course completion certificate.
Signature of Principal/ HOD
850
4.5 cm x 3.5 cm
Date: Seal
(For use as the eligibility certificate only for final year or backlog applicants)
Zonal GATE Office Contact
Chairman GATEIndian Institute of Technology Bombay
Powai, Mumbai, 400076
7e919fec809c78970b019a4675f9c1a0
Applicant's recent photograph
178 J 436 J
GATE Exam Details
(Mobile No.)
(Exam City 2)
Principal Certificate
This is to certify that Shafaque Sheikh is a student enrolled in
Applicants signature inside the box in black inkDate: ....../....../............
India
She is a student of the final year of B.E..
anjuman college of engineering and technology, nagpur.
nagpur
Application Form
Do not AttestDo not sign on photo