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    T349N70ApplicationForm 2

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    Pavan Sai
    This document is an application form for the GATE 2024 exam. It contains information about the applicant such as name, date of birth, gender, category, contact details, qualification details including college name and year of graduation. It also lists the applicant's preferred exam cities and paper code. At the bottom is a declaration by the applicant confirming eligibility and accuracy of information provided in the form.

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    © All Rights Reserved
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    T349N70ApplicationForm 2

    Uploaded by

    Pavan Sai
    10 views1 page
    This document is an application form for the GATE 2024 exam. It contains information about the applicant such as name, date of birth, gender, category, contact details, qualification details including college name and year of graduation. It also lists the applicant's preferred exam cities and paper code. At the bottom is a declaration by the applicant confirming eligibility and accuracy of information provided in the form.

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    T349N70ApplicationForm-2

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    This document is an application form for the GATE 2024 exam. It contains information about the applicant such as name, date of birth, gender, category, contact details, qualification details including college name and year of graduation. It also lists the applicant's preferred exam cities and paper code. At the bottom is a declaration by the applicant confirming eligibility and accuracy of information provided in the form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    10 views1 page

    T349N70ApplicationForm 2

    Uploaded by

    Pavan Sai
    This document is an application form for the GATE 2024 exam. It contains information about the applicant such as name, date of birth, gender, category, contact details, qualification details including college name and year of graduation. It also lists the applicant's preferred exam cities and paper code. At the bottom is a declaration by the applicant confirming eligibility and accuracy of information provided in the form.

    Copyright:

    © All Rights Reserved
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    Application Form

    Zone/Scrutiny Code

    6OB T349N70

    T349N70 (Enrollment ID)

    LAKSHMI DURGA ANAND KUMAR SAMUDRAPU


    (Full Name of the Applicant)

    28 May 2003 Male OBC-NCL


    (D.O.B) (Gender) (Category)

    Indian +91-9494842354 SAMUDRAPU ANIL KUMAR


    National (Parent/Guardian's Mobile Number) (Parent/Guardian's Name)

    Communication Address GATE Exam Details


    H.NO-3-71,venkateswara poultry farm GATE Paper Code
    near mahamkallimma temple,mahadevapatnam
    undi mandal,westgodavari
    Mahadevapatnam
    Andhra Pradesh 534199
    CE
    +91-9494842354 (Mobile No.) (Civil Engineering)
    anandkumarsamudrapu143@gmail.com

    Exam City 1 : Tadepalligudem (AP)


    Qualification Details Exam City 2 : Visakhapatnam (AP)
    B. Tech Exam City 3 : Vizianagaram (AP)
    Civil Engg.
    Graduated: No; Year of Graduation: 2024 Zonal GATE Office Contact
    SAGI RAMA KRISHNAM RAJU ENGINEERING COLLEGE GATE Office
    Indian Institute of Technology Kharagpur
    China amiram.,West godavari Kharagpur 721302
    Andhra Pradesh 534204
    gateonline@adm.iitkgp.ac.in, 03222-282091

    DECLARATION
    I confirm that I fulfil the eligibility criteria to appear for the Graduate Aptitude Test in Engineering (GATE 2024) examination. I have read the Information
    Brochure and filled up the GATE 2024 Application Form myself. I agree to strictly comply with the code of conduct for GATE 2024 examination as detailed in
    the Information Brochure. I confirm that the information provided by me in this form is correct. I also confirm that I am NOT filling more than one Application
    Form for myself.
    If any of the information provided by me is found to be incorrect later, I understand that my candidature for GATE 2024 may be cancelled, before, during, or
    after the examination, including the time after generation of my GATE 2024 Score Card. Further, I understand that I may be liable for legal action for
    providing false information. GATE 2024 Examination Body’s decision will be final and legally binding on me.
    I also understand that GATE is NOT an admission ensuring examination, and qualifying in GATE examination does NOT guarantee admission, scholarship,
    or a job. GATE 2024 Examination Body shall NOT be liable for any legal obligations arising out of this matter.
    I am aware that the data provided by me during the application process as well as my GATE results may be shared for admission or recruitment purposes.

    e-Signature : null
    Digital Fingerprint : c7e00f9b198034f1ed6ef95f45d24fc3

    PROVISIONAL APPLICATION SUBJECT TO PAYMENT

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