GAUTAM BUDDHA UNIVERSITY

EDUCATION ENLIGHTENED

Application Form Gautam Budh Nagar (U.P.)

GPT/GPTU 2012
Programme Code (Refer section 4.0 in brochure)
Architecture & Planning (Please Tick )
1. Name of candidate (in Full) (As per 10th certificate) 2. (a) Fathers Name Occupation (b) Mothers Name Occupation Date Month Year 3. Date of Birth (As per 10th certificate) 4. Gender (Please Tick) 5. Name of State of Domicile 7. Category (Please Tick) 8. Tick (if applicable) SC ST OBC Male Female 6. Nationality GEN Physically Handicapped Woman Affix Recent Passport Size Photograph

Yes

No

Dependents of Freedom Fighters Dependents of Defence Personnel

(Retired/handicapped/war deceased)

9. Address for correspondence Pin Code Mobile No.

E-mail

10. Preference of Examination/Interview Center Name 1.

(Refer the section 9.0, page No. 30-31 in brochure)

11. Academic Qualification

S. NO. 1. 2. 3. 4. Examination Passed 12th Graduation...................
Please specify the stream

2.
Board/College/University Year of passing Max. Marks

3.
Marks Obtained % of Marks/CGPA

Post Graduation.............
Please specify the stream

Other Qualifications

Demand Draft No.: Issuing Bank Name: Payable at New Delhi

DD Date: Amount:

Declaration
The above furnished information is true to the best of my knowledge and I understand that in case of anything found misleading or wrong my candidature is liable to be rejected without any notice. Date : Place: Signature of Parents/Guardian Signature of Candidate

GAUTAM BUDDHA UNIVERSITY

EDUCATION ENLIGHTENED...

Admit Card Gautam Budh Nagar (U.P.)

GPT/GPTU 2012
Programme Code: Name of Candidate (in block letters) Fathers/ Mothers Name : Date of Birth : Address for Correspondence :

Roll No :
Affix Recent Passport Size Photograph

Pin code
S. NO. 1. Programme Name

Mobile No.
Programme Code Date of Test / Interview Time of Test / Interview

Examination / Interview Centre Name : ______________________________________ (for office use only)

Code

Signature of Candidate Note : Entry to Examination hall will be permitted with this Admit card only. Reporting time: Half an hour before commencement of test.

Chairman (Admissions)

GAUTAM BUDDHA UNIVERSITY

EDUCATION ENLIGHTENED...

Verification Card

Gautam Budh Nagar (U.P.)

Programme Code: Name of Candidate (in block letters) Fathers/ Mothers Name : Date of Birth :

Roll No :
Affix Recent Passport Size Address for Correspondence : Photograph

Pin code
S. NO. 1. Programme Name

Mobile No.
Programme Code Date of Test / Interview Time of Test / Interview

Examination / Interview Centre Name : ______________________________________ (for office use only) Signature of Invigilator Signature of Candidate
(at the time of Examination)

Code

Name of Invigilator

Signature of Center Superintendent