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Secon I
S.No
Name of the Instutes Applied
Course
Applied
1A
Anything more you wish to share
____________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
CLAIM FORM
Name: Date of Birth:
Current Mobile No.: Email:
Student details
Year of enrollment: GATEFORUM Roll No.: Stream:
Course: City:
Registered Email ID:
Registered mobile Number:
Enrollment Details
Result Details
GATE Year: Stream Appeared:
GATE Rank: GATE Score: GATE Marks:
Students who have opted for ME/M.Tech/MS programs for the
academic year 20152016 in IISC or any IIT, both can also be
lled. please ll the Secon I of the form and students who have
been selected in a PSU please ll the Secon II of the form.
Ax Latest
Passport Size
Photograph Here
Final Instute Selected
Courses / Instute you
got a Interview / Direct
Admission call from
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2A Share your tests and interview experience at various
instutes
Name of InstuteSelecon
ProcedurePaern of the Test
Topics Covered during Interview & Test
Interview Quesons
_____________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
3A Please ll in the details of the Fees paid.
S.No. Details JulyDec 2015
(Rs.) JanMay 2016
(Rs.)
Sanconed Amount
(To be lled by
GATEFORUM)
1
Semester Fees
2
Hostel Fees
3
Any other Academic
Fees Paid
Total Fees
3B Bank & Account Details
Account Number:
Account Holders Name:
Name of the Bank: City:
Branch:
Note: Incase the Bank account provided doesnt belong to the
student please menon the relaon
with the student along with his contact details
Relaon with the Student :
Mobile Number :
IFSC code:
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Anything more you wish to share
____________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Secon II
A
S.No
Name of the PSU Applied
Posion
Applied
PSUs you got a
Interview call from
Name of the PSU you
have been
selected
I Share the details of PSUs you applied
Share your tests and interview experience at various PSUs
Name of PSU Selecon
Procedure
Group Discussion Topics
( If applicable)
IB
Interview Quesons
_____________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
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Paern of the Test
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Scholarship Details:
Fee reimbursement for rst year of ME/M.Tech/MS programs for the
academic year 20152016 in IISc or
any IIT
Fees will be reimbursed in 2 semesters; GATEFORUM will reimburse
only the tuion fees and hostel fees.
One me deposits will not be reimbursed.
Students joining PSUs will be given an Android Tab
Terms & Condions:
1) It's mandatory for a student to give a minimum of 4
seminars/workshops in order to claim his/her
reimbursement fees in 2nd semester.
2) Its mandatory for students to ll GATEFORUM alumni network in
100pins.com.
3) Student receiving GATEFORUM Financial Scholarship will
represent GATEFORUM as its brand ambassador
for his enre term with IIT's / IISc.
4) Student should have no associaon with any other GATE instute
during their term with IIT's / IISc.
5) GATEFORUM may contact you for assignments that include
teaching (in regular classroom sessions, eGATE
etc), content development and review and seminars at colleges
etc.
6) Students details may be shared with Media journalist if they
wish to cover any story on GATE toppers.
7) Students should not be involved in any unlawful acvies, both
inside and outside of the campus. If any
report of such involvement comes to light, GATEFORUM reserves
the right to cancel the scholarship on
disciplinary grounds.
8) Students should not try manipulang any receipts received from
IIT /IISc to claim more, incase
GATEFORUM nds any such case the scholarship will be immediately
cancelled and the same shall be
informed to the concerned authories in the campus.
9) GATEFORUM reserves the right to use student's informaon in
its adversements and promoonal
materials etc to promote its products and services.
10) GATEFORUM reserves the right to cancel the GATEFORUM
scholarship program any me without any
prior nocaon.
11) In case of any dispute GATEFORUM decision is nal and no
claim shall be entertained.
I cerfy that I have veried all the entries with the lledin C F
and there is No error in it. I am fully responsible
for the errors, I have also read the terms & condions and
agree on the same
Signature of the Student
1) Fee Receipt
2) GATE Score Card
3) College Id Card
4) Admission Leer
Please scan and upload the below menoned documents (Original
Copy) along with claim form
1) Oer leer
2) Payslip
3) GATE Score Card
4) Oce ID Card
Student opng for MTECH in IISc/IIT:
Student opng for PSUs:
Documents CheckList
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