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7CP
To
GATE 2013
Chairman GATE Indian Institute of Technology Madras Chennai, 600036
From Kaviarasu K
1/204 PANCHALANKURICHI CEYLON COLONY OTTAPIDARAM TUTICORIN Tamil Nadu, 628401
213 G 320 H
80986 68729
(Mobile No.)
Cut Here
Note: Application ID - 213 G 320 H. You should preserve this number for further correspondence.
Zone/Scrutiny Code
7CP
213 G 320 H
4.5 cm x 3.5 cm
(Application ID)
Kaviarasu K
(Full Name of Applicant)
213 G 320 H
06 Sep 1991
(D.O.B)
Male
Kandeepan B
(Name of Parent)
OBC-NC
Indian National
Communication Address
1/204 PANCHALANKURICHI CEYLON COLONY OTTAPIDARAM TUTICORIN Tamil Nadu, 628401 India
Madurai, TN
(Exam City 1)
Dindigul, TN
(Exam City 2) Scribe Assistance Required:
No
Qualification Details
B.E. Electrical Engg./Electrical and Electronics Engg./Power Graduated: No, Year of Graduation: 2013 vickram college of engineering sivagangai Tamil Nadu, 630561
Enclosure Checklist
Stamped Bank Challan: GATE copy
Payment Details
I hereby declare that all the particulars stated in this application form are true to the best of my knowledge and belief. I have read the Information Brochure and I shall abide by the terms and conditions therein. 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 2013. Further, if any suppression or distortion of facts is found after appearing in the exam, any admission/degree acquired on the basis of GATE 2013 score is liable to be cancelled.
Date: ....../....../............
Principal Certificate
(For use as the eligibility certificate only for final year or backlog applicants)
This is to certify that Kaviarasu K is a student enrolled in vickram college of engineering, sivagangai. He is a student of the final year of B.E.. He appeared in the final semester/year exam of the above degree, but has a backlog to be cleared from an earlier semester/year, and therefore cannot produce a course completion certificate.
Date:
Seal