Shri Shivaji College Of Arts, Commerce & Science, Akola

ALUMNI ASSOCIATION FORM

ALUMNI ASSOCIATION OF SHRI SHIVAJI COLLGE OF ARTS, COMMERCE & SCIENCE, AKOLA

ADDRESS : SHRI SHIVAJI COLLGE OF ARTS, COMMERCE & SCIENCE, NEAR SHIVAJI PARK, AKOLA


APPLICATION FORM FOR MEMBERSHIP


To,
The Secretary,
Alumni Association of
Shri. Shivaji College of Arts, Commerce, & Science,
Akola 444001

Dear Sir/Madam,

I'm X-Student of our college, I would like to enroll as member of alumni association. For all studnets Junior/Senior/Post Graduate/Research.


My Personal Information as Below


01. Full Name(in BLOCK letters) SURNAME MIDDLENAME LASTNAME
02. Date of Birth [D][D]/[M][M]/[YYYY]
03. Educational Qualification ___________________________
04. Year of passing from this college. (Please Indicate Jr./Sr./PG/Reaserch) ___________________________
05. Present Status (Employed/Business/Self) (Please Indicate) ___________________________
06. Address (Official/Correspondance) ___________________________
07. Contact No. & eMail ___________________________
08. Any Significant Achievements ___________________________
09. Please give three names of your classmate and their present Address/Ph.No./eMail. ___________________________

Date : __/__/_____.

Yours Faithfully

Signature

:: Fill and post it to above address or send it to alumni@shivajiakola.org ::