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Page - 4 : Address slip to be pasted on the A4 size envelope

7.

Instructions for the Candidate:

1.2.

Page - 1: Instructions for the candidate to be retained by you carefully3.

4.

5.

a. Paste your recent color photo (3cm x 4cm) in designated place

b. Sign at designated places

6.

There are 4 Pages in this file. These pages should be printed on A4 sheets.

Page - 2 : Application Form (GATE Copy)

Page - 3 : Application Form (CANDIDATE Copy) to be retained by you for your reference

ONLINE Application for GATE 2011

Your Login ID is NEHA01052. Remember your password and do not disclose it to anyone.

Insert completed Application Form (GATE Copy) and attested copies of all applicable documents(SC/ST/PD Certificate, Affidavit for change of name) into A4 size envelope, without folding and sendSpeed Post (preferably) or by Registered Post to Chairman, GATE, IIT Delhi

List of Documents to be sent to GATE IIT Delhi:

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List of Documents to be sent to GATE IIT Delhi:

APPLICATION FORM FOR GATE 2011

Application No:

Zone:

3153526

IIT Delhi

Name of the Candidate as in

the 10th Class Certificate

Date of Birth (DD/MM/YYYY)

Gender

Category

Person with Disability (PD)

Qualifying Degree

Nationality

Choice of Examination City1

Choice of Examination City2

Choice of GATE Paper

Year of Degree

Discipline

Name of Parent

State/Union Territory ofPermanent Residence

1.

2.

3.

5.

6.

7.

4.

8.

9.

14.

15.

16.

17.

FEMALE

OBC(Non-Creamy Layer)

No

B.E./B.Tech./ B.Sc.(Engg.)/B.Sc.(Tech.)/B.Arch.

INDIAN

313 - Indore

319 - Ujjain

CS - Computer Science and InformationTechnology

2011

Information Technology

NARENDRA CHOUHAN

Madhya Pradesh

Address 56, SUNDAR NAGAR MAIN

INDORE (MADHYA PRADESH)

11.

PINCODE of Addressfor Correspondence

Phone / MobileNumber

18.

19. 452001

09826158584

GATE IIT Delhi C

Do You Require a Scribe? No

NEHA CHOUHAN

01/05/1990

Payment Mode:

Application Fee: Rs. 800/-

452001PINCODE

HDFC Payment Gateway

02970155285Payment Reference No:

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APPLICATION FORM FOR GATE 2011

Application No:

Zone:

3153526

IIT Delhi

Name of the Candidate as in

the 10th Class Certificate

Date of Birth (DD/MM/YYYY)

Gender

Category

Person with Disability (PD)

Qualifying Degree

Nationality

Choice of Examination City1

Choice of Examination City2

Choice of GATE Paper

Year of Degree

Discipline

Name of Parent

State/Union Territory ofPermanent Residence

1.

2.

3.

5.

6.

7.

4.

8.

9.

14.

15.

16.

17.

FEMALE

OBC(Non-Creamy Layer)

No

B.E./B.Tech./ B.Sc.(Engg.)/B.Sc.(Tech.)/B.Arch.

INDIAN

313 - Indore

319 - Ujjain

CS - Computer Science and InformationTechnology

2011

Information Technology

NARENDRA CHOUHAN

Madhya Pradesh

Address 56, SUNDAR NAGAR MAIN

INDORE (MADHYA PRADESH)

11.

PINCODE of Addressfor Correspondence

Phone / MobileNumber

18.

19. 452001

09826158584

CANDIDATE C

Do You Require a Scribe? No

NEHA CHOUHAN

01/05/1990

Payment Mode:

Application Fee: Rs. 800/-

452001PINCODE

HDFC Payment Gateway

02970155285Payment Reference No:

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APPLICATION NO

GATE

From

PINCODE

To

PINCODE

BY SPEED POST / REGISTERED POST

2011

NEHA CHOUHAN

56, SUNDAR NAGAR MAIN

INDORE (MADHYA PRADESH)

3 1 5 3 5 2 6

Chairman, GATE

Indian Institute of Technology Delhi

Hauz Khas, New Delhi

313

GATE PAPER CODE

EXAM CITY OF FIRSTCHOICE

CS

4 5 2 0 0 1

Page

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