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T137 F20 Application Form

The document is an application form for the GATE exam. It contains information such as the applicant's name, date of birth, gender, address, education details, GATE paper and exam city details, declaration, and digital signature.

Uploaded by

SOHAM CHATTERJEE
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15 views

T137 F20 Application Form

The document is an application form for the GATE exam. It contains information such as the applicant's name, date of birth, gender, address, education details, GATE paper and exam city details, declaration, and digital signature.

Uploaded by

SOHAM CHATTERJEE
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Application Form

Zone/Scrutiny Code

4GE T137F20

T137F20 (Enrollment ID)

SOHAM CHATTERJEE
(Full Name of the Applicant)

04 Jul 2001 Male GEN


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

Indian +91-8001194789 SHRI RAJAT CHATTERJEE


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

Communication Address GATE Exam Details


SREE SREE APARTMENT, BENGAL AMBUJA, DURGAPUR GATE Paper Code
38 TOWN HALL PARA, BURDWAN
Durgapur
West Bengal 713216
+91-7908598995 (Mobile No.)
CS
[email protected] (Computer Science and
Information Technology)

Exam City 1 : Durgapur (WB)


Qualification Details Exam City 2 : Asansol (WB)
B. Tech Exam City 3 : Burdwan (WB)
Computer Science & Engg.
Graduated: Yes; Year of Graduation: 2023 Zonal GATE Office Contact
DR. B.C. ROY ENGINEERING COLLEGE GATE Office
Fuljhore.,Paschim bardhaman Indian Institute of Technology Guwahati
West Bengal 713206
Guwahati 781039
[email protected], 0361-2582751

DECLARATION
I confirm that I fulfil the eligibility criteria to appear for the Graduate Aptitude Test in Engineering (GATE 2024) examination. I have read the Information
Brochure and filled up the GATE 2024 Application Form myself. I agree to strictly comply with the code of conduct for GATE 2024 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 2024 may be cancelled, before, during, or
after the examination, including the time after generation of my GATE 2024 Score Card. Further, I understand that I may be liable for legal action for
providing false information. GATE 2024 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 2024 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 : Soham Chatterjee


Digital Fingerprint : 35787f349733af167546b380dc14e307

PROVISIONAL APPLICATION SUBJECT TO PAYMENT

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