Documente Academic
Documente Profesional
Documente Cultură
Zone/Scrutiny Code
2AL
GATE 2013
To
Chairman GATE
Indian Institute of Technology Bombay
Powai, Mumbai, 400076
From
Aayush Anand
187 Mig
107 E 486 H
Hanuman Nagar
Patna
Bihar, 800020
94298 97175
(Mobile No.)
Cut Here
Note: Application ID - 107 E 486 H. You should preserve this number for further correspondence.
GATE 2013
Application Form
Zone/Scrutiny Code
2AL
107 E 486 H
4.5 cm x 3.5 cm
(Application ID)
Aayush Anand
(Full Name of Applicant)
107 E 486 H
15 Feb 1987
Male
Do not Attest
Do not sign on photo
GEN
(D.O.B)
Indian National
Communication Address
187 Mig
EE
Hanuman Nagar
Patna
Bihar, 800020
India
Ahmedabad, GJ
(Exam City 1)
Rajkot, GJ
(Exam City 2)
aayushchill@gmail.com
94298 97175 (Mobile No.)
No
Qualification Details
B.E.
Electrical Engg./Electrical and Electronics Engg./Power
2009
Manipal Institute Of Technology
Manipal
Karnataka, 576104
Chairman GATE
Indian Institute of Technology Bombay
Powai, Mumbai, 400076
Payment Details
Online
Rs. 1200.00
MICI2804308587
06/09/2012
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: ....../....../............