082267

1. Employment Notice No

PLR/GET(GATE-2013)/Recruitment/191 Dt.05.07.2013

2. Name of the Post & Post No.

Graduate Engineer Trainee (C&I)-2013/13

3. Name of the applicant in Full:

SHIKHA TOMAR

4. Gate 2013 Scorecard Registration No. :

53322330

5.GATE Paper Code :

IN

6. Date of Birth :

27-JAN-1990

7.Age as on 01.07.2013 :

23

8. Fathers/Husbands Name

FATHER

9. Gender

Female

10. Category

GENERAL

11. Physically Handicapped

NO

12.Address for Communication

C-702,

Please self-attest your photo

P.O.

Sarojini Nagar

State

Delhi

Nearest Railway Station

E-mail Id

JUGENDRA SINGH

City/Town New Delhi

District Delhi

New Delhi NDLS

PIN 110023

shikha.tomar279@gmail.com

Mobile No. 8130148119

C-702,

13. Permanent Address

P.O.
District
PIN

Sarojini Nagar

City/Town New Delhi

Delhi

State Delhi

110023

14. Marital Status

Single

15. Nationality

Indian

16. Religion

Hindu

17. Educational Qualifications

a)Starting from School Final onwards:

SL

Name of the Exam

Name of Board /
University

Whether
full time
regular

Discipline/Major
Subjects taken

Year of % Marks in
Passing aggregate (not
to be rounded

Class X

CBSE

YES

Maths, Science,
Social Studies,
English, Sanskrit

2006

91

+2/HS/Intermediat
e

CBSE

YES

Physics, Chemistry,
Maths, English,
Biology

2008

83.2

B.Sc./Diploma

NA

YES

NA

b) Professional Qualifications :

Submitted:

24-AUG-2013 01:32:50

BE/B.Tech./B.SC.Engg.(each semester)

Page 1 of 3

082267

SL

Exams
Passe
d

Marks
Obtained

Total Marks

Month/Year
of Passing

% marks in
aggregate
(not to be
rounded off)

Remarks, if any

1st Sem

746

1000

01/2010

74.6

2nd Sem

688

1000

06/2010

68.8

3rd Sem

690

1000

01/2011

69

4th Sem

751

1000

06/2011

75.1

5th Sem

787

1000

01/2012

78.7

6th Sem

775

1000

06/2012

77.5

7th Sem

791

1000

01/2013

79.1

8
8th Sem
TOTAL :

818
6046

1000
8000

07/2013

81.8

Total % of marks in all 8 semester :

75.58

c) Name of the College/Institution :

Institute of Engineering and Technology, Lucknow

d) Whether College/Institution appproved by AICTE :

YES

e)Whether Full-time Regular course :

YES

f) Branch/Stream Name :

Electronics and Instrumentation Engineering

18.Experience details if any

NA

19. Visible marks of identification

Mole on left hand

20. Extra-Curricular Activities

Had been the Co-ordinator of fine arts team in College Cultural Fest.

21. Details of any Criminal/Civil/ Vigilance case

in which the candidate is involved.

NA

22. Are you Govt./Semi govt/Public Sector Undertaking

NO

(If yes,NOC is required at the time of PI)

23.Are you Dvc Departmental Candidate :

NO

(If yes,NOC is required at the time of PI)

24.Particulars of Application Fee(For GEN & OBC Candidates only) :
Journal No.

Date

Amount

Branch Code

016812500

14-AUG2013

Rs.300

1536

25. Particulars of enclosure in support of claim.:

DECLARATION
I, do hereby declare that all the statements made in this application are true, complete, correct and in the event of any information being
found false, incomplete, incorrect or concealing the fact, my candidature may be cancelled at any stage without any notice and without
Place:

Signature of Candidate

Date:
Please put your clear left thumb impression
(LTI)In the box on the right hand side

Submitted:

24-AUG-2013 01:32:50

Page 2 of 3

082267

THE CHECK LIST(part of Application Format)

Documents to be brought in Orignal as well as Self-attested Photocopies at the time of GD,PT & PI.
[A copy of the checklist duly ticked at appropriate places is to be attached as part of the hard copy of the application]
A) Self attested copies of following attached.
i) Secondary School Certificate for verification of date of birth

Yes / No

ii) SC/ST/OBC(NCL) certificate in GOI format, if applicable

Yes / No

iii) PH Certificate from competent authority, if applicable, in GOI format

Yes / No

iv) Degree/Provisional Degree in support of Educational Qualifications

Yes / No

v) Mark sheets (semester/year wise) of B.Tech/B.E./B.Sc.Engg.

Yes / No

vi) Score Card of GATE-2013

Yes / No

vii) Experience Certificate, if any

Yes / No

viii) NOC, if applicable

Yes / No

ix) Challan for Application Fee (DVC's copy)

Yes / No

B) Documents furnished as follows in addition to above.

i) Signed across the scanned photo

Yes / No

ii) Stapled 3 (three) identical photos duly signed on front and details
like name and post no. written on back of each photo

Yes / No

iii) Signed the DECLARATION part of application

Yes / No

iv) Whether put your left thumb impression at appropriate place

Yes / No

Submitted:

24-AUG-2013 01:32:50

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