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    R163 N22 Application Form

    Uploaded by

    Harsh Sharma

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    R163 N22 Application Form

    Uploaded by

    Harsh Sharma
    1 views1 page

    Original Title

    R163N22ApplicationForm (4)

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    1 views1 page

    R163 N22 Application Form

    Uploaded by

    Harsh Sharma

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Application Form

    Zone/Scrutiny Code

    3EW R163N22

    R163N22 (Enrollment ID)

    HARSH SHARMA
    (Full Name of the Applicant)

    30 Dec 2004 Male GEN-EWS


    (D.O.B) (Gender) (Category)

    Indian +91-6395281584 RAJENDRA PRASAD SHARMA


    National (Parent/Guardian's Mobile Number) (Parent/Guardian's Name)

    Communication Address GATE Exam Details


    B-702,Sun Valley,Behind New Collectorate, GATE Paper Code
    City Center Extension,Gwalior
    Gwalior
    Madhya Pradesh 474011
    +91-9302660709 (Mobile No.)
    CE
    [email protected] (Civil Engineering)

    Qualification Details
    Exam City 1 : Indore (MP)
    B. Tech
    Exam City 2 : Ujjain (MP)
    Civil Engg.
    Graduated: No; Year of Graduation: 2026 Exam City 3 : Kota (RJ)
    INDIAN INSTITUTE OF TECHNOLOGY INDORE
    Simrol.,Indore Zonal GATE Office Contact
    Madhya Pradesh 453552 GATE Office
    Indian Institute of Technology Delhi
    Hauz Khas, New Delhi 110016
    Payment Details [email protected], 011-26591749
    Payment Mode Transaction Ref. No Transaction Date Amount Payment For
    Unified Payments 113448980837 9/5/24, 10:24 PM 1800.00 Application Fee

    DECLARATION
    I confirm that I fulfil the eligibility criteria to appear for the Graduate Aptitude Test in Engineering (GATE 2025) examination. I have read the Information
    Brochure and filled up the GATE 2025 Application Form myself. I agree to strictly comply with the code of conduct for GATE 2025 examination as detailed in
    the Information Brochure. I confirm that the information provided by me in this form is correct. I also confirm that I am NOT filling more than one Application
    Form for myself.
    If any of the information provided by me is found to be incorrect later, I understand that my candidature for GATE 2025 may be cancelled, before, during, or
    after the examination, including the time after generation of my GATE 2025 Score Card. Further, I understand that I may be liable for legal action for
    providing false information. GATE 2025 Examination Body’s decision will be final and legally binding on me.
    I also understand that GATE is NOT an admission ensuring examination, and qualifying in GATE examination does NOT guarantee admission, scholarship,
    or a job. GATE 2025 Examination Body shall NOT be liable for any legal obligations arising out of this matter.
    I am aware that the data provided by me during the application process as well as my GATE results may be shared for admission or recruitment purposes.

    e-Signature : Harsh Sharma


    Digital Fingerprint : 9b3804bd6f8e5830e8861524e8c87913

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