Alumni Membership Form : Triveni Devi Bhalotia College

TRIVENI DEVI BHALOTIA COLLEGE, RANIGANJ

ALUMNI ASSOCIATION LEGACY MEMBERSHIP FORM

Please read the instructions carefully before filling the Membership form:

1. You are eligible for Triveni Devi Bhalotia College, Raniganj Alumni Association Membership only if you are an Ex-student of this College.
2. Fill the entire field online carefully. Mention correct Phone no. and Email ID
3. Upload a scanned copy (in pdf/ jpg format) of document as proof that you are an Ex-student of this College. Also upload your recent passport size colour photograph
4. After successful submission of filled form you will get an auto-generated mail. Please do not reply.
5. Within 2-3 working days your form will be verified and you will receive an E-Certificate in your mail regarding that you are a registered Alumni Association Member of this College.

PERSONAL DETAILS

Salutation:

Name (in full):

Father's/Mother's/Spouse Name:

Date of Birth:

Marital Status:

Blood Group:

Present Occupation:

Upload recent passport size colour photograph:
(in jpg format. File size to be less than 1.5MB)

CONTACT DETAILS

Contact Number:

Alternate Phone No. (Optional):

Email Id:

Present Address:

COLLEGE DETAILS

Year of Passing:

Stream of Study:

Select any one of the document (optional):

Upload Scanned Document [as proof] (optional):
(in pdf/jpg format. File size to be less than 500kb)

I declare that all the information provided by me is true to the best of my knowledge. In case of any discrepancy my membership will not remain valid.

TRIVENI DEVI BHALOTIA COLLEGE, RANIGANJ

ALUMNI ASSOCIATION LEGACY MEMBERSHIP FORM

Please read the instructions carefully before filling the Membership form:

PERSONAL DETAILS

CONTACT DETAILS

COLLEGE DETAILS

*(if this is accepted you will receive an auto-generated mail for successful submission)

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