ONLINE Application for GATE 2011

Instructions for the Candidate:

1.
Your Login ID is SUDH0104. Remember your password and do not disclose it to anyo
ne.
2.
There are 4 Pages in this file. These pages should be printed on A4 sheets.
3.
Page - 1: Instructions for the candidate to be retained by you carefully
4.
Page - 2 : Application Form (GATE Copy)
a.
Paste your recent color photo (3cm x 4cm) in designated place
b.
Sign at designated places
5.
Page - 3 : Application Form (CANDIDATE Copy) to be retained by you for your refe
rence
6.
Page - 4 : Address slip to be pasted on the A4 size envelope
7.
Insert completed Application Form (GATE Copy) and attested copies of all applica
ble documents
(SC/ST/PD Certificate, Affidavit for change of name) into A4 size envelope, with
out folding and send by
Speed Post (preferably) or by Registered Post to Chairman, GATE, IISc Bangalore
List of Documents to be sent to GATE IISc Bangalore:
1.
Application Form (GATE Copy)
2.
Attested Copy of SC/ST/PD Certificate (if applicable)
3.
Attested Copy of affidavit for change of name (if applicable)
Page - 1
APPLICATION FORM FOR GATE 2011
GATE IISc Bangalore COPY
Application No: 1108692 Payment Mode: HDFC Payment Gateway
Zone: IISc Bangalore Application Fee: Rs. 800/Payment
Reference No: 029322271303
1.
Name of the Candidate as in SUDHANVA B 11. Address #615,SUMADHWA NILAYA
the 10th Class Certificate
8TH MAIN ROAD,B.H.C.S LAYOUT
UTTARAHALLI MAIN ROAD
2.
Date of Birth (DD/MM/YYYY) 01/04/1990
SUBRAMANYAPURA
POST,BANGALORE
PINCODE 560061
3.
Gender MALE
4.
Nationality INDIAN 14. Year of Degree 2011
15. Discipline Electronics & Comm./Electronics
5.
Category General
Engg./Comm.
Engg./Telecommunication Engg.
6.
Person with Disability (PD) No
Do You Require a Scribe? No
16. Name of Parent RAMAKRISHNAIAH B
7.
Qualifying Degree B.E./B.Tech./ B.Sc. 17. State/Union Territory of Karnataka
(Engg.)/B.Sc.(Tech.)/B.Arch. Permanent Residence
18.
Phone / Mobile 08026396297
8.
Choice of Examination City1 103 - Bangalore
Number
19. PINCODE of Address 560061
Choice of Examination City2 111 - Mysore
for Correspondence
9.
Choice of GATE Paper EC - Electronics and Communication
Engineering
10. E-mail Address
sudhanvarocks@gmail.com
I hereby declare that all the particulars stated in this application form are tr
ue to the best of my knowledge and belief. In the event of
suppression or distortion of any fact in my application form, I understand that
I will be denied the opportunity to appear in GATE 2011.
Further, if any such suppression or distortion of facts is found after appearing
in the exam, any admission/degree acquired on the basis of
GATE 2011 score is liable to be cancelled.
Place:
Date:
Full Signature of the Candidate
(do not sign in capital letters)

12 . Photograph

Paste a front
facial high
contrast recent
color photograph
3cm x 4cm
without any
signature or
attestation
Full Signature of the Candidate
using black ball point pen only
(do not sign in capital letters)
1108692 13.
Send this form along with the necessary documents to IISc Bangalore
Page - 2
CANDIDATE COPY
APPLICATION FORM FOR GATE 2011
Application No: 1108692 Payment Mode: HDFC Payment Gateway
Zone: IISc Bangalore Application Fee: Rs. 800/Payment
Reference No: 029322271303
1.
Name of the Candidate as in SUDHANVA B 11. Address #615,SUMADHWA NILAYA
the 10th Class Certificate
8TH MAIN ROAD,B.H.C.S LAYOUT
UTTARAHALLI MAIN ROAD
2.
Date of Birth (DD/MM/YYYY) 01/04/1990
SUBRAMANYAPURA
POST,BANGALORE
PINCODE 560061
3.
Gender MALE
4.
Nationality INDIAN 14. Year of Degree 2011
15. Discipline Electronics & Comm./Electronics
5.
Category General
Engg./Comm.
Engg./Telecommunication Engg.
6.
Person with Disability (PD) No
Do You Require a Scribe? No
16. Name of Parent RAMAKRISHNAIAH B
7.
Qualifying Degree B.E./B.Tech./ B.Sc. 17. State/Union Territory of Karnataka
(Engg.)/B.Sc.(Tech.)/B.Arch. Permanent Residence
18.
Phone / Mobile 08026396297
8.
Choice of Examination City1 103 - Bangalore
Number
19. PINCODE of Address 560061
Choice of Examination City2 111 - Mysore
for Correspondence
9.
Choice of GATE Paper EC - Electronics and Communication
Engineering
10. E-mail Address
sudhanvarocks@gmail.com
I hereby declare that all the particulars stated in this application form are tr
ue to the best of my knowledge and belief. In the event of
suppression or distortion of any fact in my application form, I understand that
I will be denied the opportunity to appear in GATE 2011.
Further, if any such suppression or distortion of facts is found after appearing
in the exam, any admission/degree acquired on the basis of
GATE 2011 score is liable to be cancelled.
Place:
Date:
Full Signature of the Candidate
(do not sign in capital letters)

12 . Photograph

Paste a front
facial high
contrast recent
color photograph
3cm x 4cm
without any
signature or
attestation
Full Signature of the Candidate
using black ball point pen only
(do not sign in capital letters)
1108692 13.
Retain this page for your reference
Page - 3
BY SPEED POST / REGISTERED POST

GATE 2011

103
GATE PAPER CODE
EXAM CITY OF FIRST
CHOICE
EC
From
PINCODE
SUDHANVA B
#615,SUMADHWA NILAYA
8TH MAIN ROAD,B.H.C.S LAYOUT
UTTARAHALLI MAIN ROAD
SUBRAMANYAPURA POST,BANGALORE
5 6 0 0 6 1
APPLICATION NO
To
PINCODE
Chairman, GATE
Indian Institute of Science Bangalore
Bangalore
5 6 0 0 1 2
1 1 0 8 6 9 2
Page - 4