Alumni Membership Form :: Bankura Sammilani College

Alumni Membership Form

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 200kb)

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:

Upload Scanned Document (as proof):
(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.

PERSONAL DETAILS

CONTACT DETAILS

COLLEGE DETAILS

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