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C294 R66 Application Form

The document contains enrollment details for the GATE exam of Shubham Pandey including personal information, address, qualifications, exam details, and payment details. Shubham Pandey has provided an electronic signature to confirm the information and agree to the code of conduct for the GATE 2023 exam.

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shubhampandey40722
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10 views

C294 R66 Application Form

The document contains enrollment details for the GATE exam of Shubham Pandey including personal information, address, qualifications, exam details, and payment details. Shubham Pandey has provided an electronic signature to confirm the information and agree to the code of conduct for the GATE 2023 exam.

Uploaded by

shubhampandey40722
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Zone/Scrutiny Code

5EW
C294R66
C294R66 (Enrollment ID)

SHUBHAM PANDEY
(Full Name of the Applicant)

19 Jul 2002 Male GEN-EWS


(D.O.B) (Gender) (Category)
Indian +91-9889530256 VIPIN KUMAR PANDEY
National (Parent/Guardian's Mobile Number) (Parent/Guardian's Name)

Communication Address GATE Exam Details


Viripur,Jamon GATE Paper Code
Pure Hanuman tiwari , viripur , Jamon
Amethi
Uttar Pradesh 227801
+91-7355406675 (Mobile No.)
EC
(Electronics and
[email protected] Communication
Engineering)
Qualification Details Exam City 1: Lucknow (UP)
Exam City 2: Ayodhya (UP)
B. Tech
Electronics & Communication Exam City 3: Varanasi (UP)
Graduated: No; Year of Graduation: 2024
RAJARSHI RANANJAY SINH INSTITUTE OF MANAGEMENT
& TECHNOLOGY Zonal GATE Office Contact
Sultanpur
Chairperson, GATE
Uttar Pradesh 227405
Indian Institute of Technology Kanpur
Payment Details Kanpur 208016

Payment Mode Transaction Ref. No Transaction Date Amount Payment For


Online order_KPIahCGjfYAHrx 10/3/22, 5:58 PM INR 1700.00 Registration

I confirm that I fulfil the eligibility criteria to appear for the Graduate Aptitude Test in Engineering (GATE 2023) examination and I, myself have filled up the
entire form in the portal. I have fully understood each and every point in the form and filled up the details accordingly. I agree to strictly comply with the code
of conduct for GATE 2023 examination as detailed in Appendix B of the Information Brochure. I confirm that the information provided by me in this form is
correct in all respect. I also confirm that I am NOT filling more than ONE form for myself.

If any of the information provided by me is found to be incorrect at any time later, my candidature for GATE 2023 will be cancelled. This cancellation of my
candidature can happen either before, during or after the examination, including the time after generation of my GATE 2023 score card, if any.

I also understand that GATE is NOT an admission ensuring examination, and qualifying in GATE examination does NOT guarantee admission / scholarship /
job. GATE 2023 committee is NOT liable for any legal obligations related to admission / job. I am aware that the data provided by me during the application
process as well as my GATE results may be shared for admission / recruitment purposes.

I shall be liable for legal action for providing any type of false information. GATE 2023 committee's decision will be final and legally binding on me.

e-Signature: Shubham Pandey


Digital Fingerprint: 2a539ec82d9ca2b759e5c2294caa8fae

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