Instructions and Application Form for GATE 2012

Transcription

1 Instructions and Application Form for GATE 2012 Instructions for the Candidate: Your Login ID is CHIN 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. 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 Application sent through courier will not be accepted. List of Documents to be attached with the Application Form: Put 1. Application Form (GATE Copy) 2. Bank Challan (GATE Copy) 3. 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). Candiates with backlog: copy of final semester/year marks sheet or course completion certificate or a letter from principal. End of Instructions

2 APPLICATION NO GATE COPY GATE 2012 APPLICATION FORM Zone: IIT Kharagpur Payment Mode: Bank Challan (SBI) Fee: Rs Name of the Candidate as in CHINTAKULA SHANMUKA 9. the 10th Class Certificate SRINIVAS Choice of GATE Paper Electronics and Communication Engineering 2. Date of Birth (DD/MM/YYYY) 10. Address 3. Gender MALE 11. Correspondence DOOR NO: /5 Nationality Category INDIAN 12. PINCODE of Correspondence 13. Year of Degree 2012 Person with Disability (PD) No 1 Discipline Electronics & Comm./Electronics Engg./Communication Engg./Telecommunication Engg 1 Name of Parent CH V V S N MURTHY Qualifying Degree B.E./B.Tech./ B.Sc. (Engg.)/B.Sc.(Tech.)/B.Arch.. State/Union Territory of Permanent Residence Andhra Pradesh Choice of Examination City Rajahmundry 1 Mobile / Landline No. Choice of Examination City Vijayawada 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 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 : 1 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 Send this form along with the necessary documents to IIT Kharagpur.

3 APPLICATION NO CANDIDATE COPY GATE 2012 APPLICATION FORM Zone: IIT Kharagpur Payment Mode: Bank Challan (SBI) Fee: Rs Name of the Candidate as in CHINTAKULA SHANMUKA 9. the 10th Class Certificate SRINIVAS Choice of GATE Paper Electronics and Communication Engineering 2. Date of Birth (DD/MM/YYYY) 10. Address 3. Gender MALE 11. Correspondence DOOR NO: /5 Nationality Category INDIAN 12. PINCODE of Correspondence 13. Year of Degree 2012 Person with Disability (PD) No 1 Discipline Electronics & Comm./Electronics Engg./Communication Engg./Telecommunication Engg 1 Name of Parent CH V V S N MURTHY Qualifying Degree B.E./B.Tech./ B.Sc. (Engg.)/B.Sc.(Tech.)/B.Arch.. State/Union Territory of Permanent Residence Andhra Pradesh Choice of Examination City Rajahmundry 1 Mobile / Landline No. Choice of Examination City Vijayawada 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 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 : 1 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 Retain this copy with you for future reference.

4 BY SPEED / REGISTERED POST (Please do not Courier) GATE 2012 Application Form To Chairman, GATE Indian Institute of Technology Kharagpur Kharagpur Do not tamper with the bar code. For GATE official use. From (APPLNO : ) DOOR NO: /

5 CASH VOUCHER BANK COPY CASH VOUCHER GATE COPY CASH VOUCHER CANDIDATE COPY RAJAHMUNDRY RURAL, RAJAHMUNDRY RURAL, RAJAHMUNDRY RURAL,