C161 Y56 Application Form

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Zone/Scrutiny Code

5GE
C161Y56
C161Y56 (Enrollment ID)

SHIVALI SINGH
(Full Name of the Applicant)

18 Aug 1997 Female GEN


(D.O.B) (Gender) (Category)
Indian +91-9198956369 MRS. SHASHI SINGH
National (Parent/Guardian's Mobile Number) (Parent/Guardian's Name)

Communication Address GATE Exam Details


Raj Veer Ln, Harihar Nagar, Kamta, Luckn GATE Paper Code
Lucknow
Uttar Pradesh 226016
+91-7897159981 (Mobile No.)
shivaliisinghh@gmail.com
AR
(Architecture and Planning)

Qualification Details Exam City 1: Lucknow (UP)


Exam City 2: Gorakhpur (UP)
B. Arch
Architecture / Architectural Engg. Exam City 3: Ayodhya (UP)
Graduated: Yes; Year of Graduation: 2021
ITM SCHOOL OF ARCHITECTURE AND TOWN PLANNING
Zonal GATE Office Contact
Lucknow
Chairperson, GATE
Uttar Pradesh 226021
Indian Institute of Technology Kanpur
Payment Details Kanpur 208016

Payment Mode Transaction Ref. No Transaction Date Amount Payment For


Online order_KMdYkCi4h7Tmb9 9/27/22, 12:32 AM INR 850.00 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: Shivali Singh


Digital Fingerprint: c910542b41930a5ccd6780e33446e310

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