Documentos de Académico
Documentos de Profesional
Documentos de Cultura
1. 2. 3. 4. Your Login ID is PADM1506. Remember your password and do not disclose it to anyone. There are 4 Pages in this file. These pages should be printed on A4 sheets. Page - 1: Instructions for the candidate to be retained by you carefully Page - 2 : Application Form (GATE Copy) a. Paste your recent color photo (3cm x 4cm) in designated place b. Sign at designated places 5. 6. 7. Page - 3 : Application Form (CANDIDATE Copy) to be retained by you for your reference Page - 4 : Address slip to be pasted on the A4 size envelope Insert completed Application Form (GATE Copy) and attested copies of all applicable documents (SC/ST/PD Certificate, Affidavit for change of name) into A4 size envelope, without folding and send by Speed Post (preferably) or by Registered Post to Chairman, GATE, IIT Kharagpur
Page - 1
8. Choice of Examination City1 Choice of Examination City2 9. Choice of GATE Paper 10. E-mail Address
09938764757 759146
I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. 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 2011. 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 2011 score is liable to be cancelled.
Place: Date:
Full Signature of the Candidate (do not sign in capital letters)
12. Photograph
6106008
13.
Full Signature of the Candidate using black ball point pen only (do not sign in capital letters)
Paste a front facial high contrast recent color photograph 3cm x 4cm without any signature or attestation
Send this form along with the necessary documents to IIT Kharagpur
Page - 2
8. Choice of Examination City1 Choice of Examination City2 9. Choice of GATE Paper 10. E-mail Address
09938764757 759146
I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. 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 2011. 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 2011 score is liable to be cancelled.
Place: Date:
Full Signature of the Candidate (do not sign in capital letters)
12. Photograph
6106008
13.
Full Signature of the Candidate using black ball point pen only (do not sign in capital letters)
Paste a front facial high contrast recent color photograph 3cm x 4cm without any signature or attestation
Page - 3
GATE 2011
GATE PAPER CODE EXAM CITY OF FIRST CHOICE
ME 604
From PADMA CHARAN BARAL ROOM NO-238,SURYA BHAWAN, INDIRA GANDHI INSTITUTE OF TECHNOLOGY, SARANG DIST- DHENKANAL, ORISSA PINCODE
PINCODE 7
APPLICATION NO
6 1 0 6 0
7 5 9 1 4 6
0 8
Page - 4