Alumni Registration Form

Fields marked with (*) are mandatory.
Registration Fee Rs. 500/-(Compulsory).
International Payment not accepted.
  First Name* Middle Name Last Name*
Student Name*
Father's Name*
Mother's Name*
Date of Birth*    
Passout Year* Last Class Attended*
Stream* Scholar No.
Highest Qualifiaction*    
Marital Status* Occupation*
Department Designation
Address* Country*
State* City*
Phone No.
(Eg-: 01452465879)
Mobile No.* +91
Email Id*     Memorable Moment
 
User Name*
Upload Image*
 
Note: Student image file size must be less then 60 kb Acceptable Image Formats: jpg, jpeg