Instructions and Application Form For GATE 2012
Instructions and Application Form For GATE 2012
Instructions and Application Form For GATE 2012
3. 4.
5. 6. 7.
8.
7.
____________End of Instructions____________
GATE COPY
11. Address for Correspondence SHUBHASHISH BHAKTA C/O: DR. T. BHAKTA,QTR.NO.IV-C REGIONAL PHARMACY COLLEGE P.O: ABHOYNAGAR, TRIPURA(WEST) 799005 2009 Electrical Engg/Electrical and Electronics Engg./Power Engg BRAJENDRA KUMAR BHAKTA Tripura
INDIAN General No
12. PINCODE of Address for Correspondence 13. Year of Degree 14. Discipline 15. Name of Parent
7. Qualifying Degree
09863430077
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
401EE4017379
Send this form along with the necessary documents to IIT Guwahati.
CANDIDATE COPY
11. Address for Correspondence SHUBHASHISH BHAKTA C/O: DR. T. BHAKTA,QTR.NO.IV-C REGIONAL PHARMACY COLLEGE P.O: ABHOYNAGAR, TRIPURA(WEST) 799005 2009 Electrical Engg/Electrical and Electronics Engg./Power Engg BRAJENDRA KUMAR BHAKTA Tripura
INDIAN General No
12. PINCODE of Address for Correspondence 13. Year of Degree 14. Discipline 15. Name of Parent
7. Qualifying Degree
09863430077
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
401EE4017379
BY SPEED / REGISTERED POST (Please do not Courier) GATE 2012 Application Form
401EE4017379
Do not tamper with the bar code. For GATE official use.
From
SHUBHASHISH BHAKTA (APPLNO : 4017379) SHUBHASHISH BHAKTA C/O: DR. T. BHAKTA,QTR.NO.IV-C REGIONAL PHARMACY COLLEGE P.O: ABHOYNAGAR, TRIPURA(WEST) 799005
CASH VOUCHER
CANDIDATE COPY
Challan can be deposited minimum one day after the generation of challan.
Name of the Candidate : SHUBHASHISH BHAKTA Address for Correspondence :
Challan can be deposited minimum one day after the generation of challan.
Name of the Candidate : SHUBHASHISH BHAKTA
Challan can be deposited minimum one day after the generation of challan.
Name of the Candidate : SHUBHASHISH BHAKTA
S H U B H A S H I S H B H A K T A C / O : D R . T . Address for Correspondence : BHAKTA,QTR.NO.IV-C REGIONAL PHARMACY COLLEGE P.O: ABHOYNAGAR, TRIPURA(WEST) - 799005
S H U B H A S H I S H B H A K T A C / O : D R . T . Address for Correspondence : BHAKTA,QTR.NO.IV-C REGIONAL PHARMACY COLLEGE P.O: ABHOYNAGAR, TRIPURA(WEST) - 799005
SHUBHASHISH BHAKTA C/O: DR. T. BHAKTA,QTR.NO.IV-C TRIPURA(WEST) - 799005 REGIONAL PHARMACY COLLEGE P.O: ABHOYNAGAR,
09863430077 bhaktamelt@gmail.com
09863430077 bhaktamelt@gmail.com
09863430077 bhaktamelt@gmail.com
General Rs.1025/- * Rupees One thousand and Twenty Five Only. (*Application Fees Including Bank Charges)
General Rs.1025/- * Rupees One thousand and Twenty Five Only. (*Application Fees Including Bank Charges)
General 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