ISLAMIC UNIVERSITY Department of English Alumni Reunion & Silver Jubilee Celebration Registration Form
Last date for registration: 20 December 2017

Event Date: 8 & 9 January 2018
Event Address: Department of English, Islamic University, Kushtia
Contact us at 071-62201-6, Ext. 2221, mobile: 01711201836, 01712191633
E-mail: <rashiduzzaman5@gmail.com>

Email address *
Instructions to follow
Step 1:
Deposit the registration fees into the bank account or bKash wallet mentioned in the 'Payment Method' section. Pay for different types of participants according to the following chart (preserve the bank receipt or bKash reference number):
1. BDT 1000 / alumnus
2. BDT 800 / spouse
3. BDT 600 / single child (aged 5 years and above)
4. BDT 500 / single driver
5. BDT 800 / single guest

Step 2:
Fill out the registration form carefully and see that you have filled the required fields before submission.

Name *
Your answer
Session *
Your answer
Mobile no. *
Your answer
Occupation *
Your answer
Organization
Your answer
Present Address *
Your answer
Number of participant(s) including the alumnus *
Required
Guest types (if applicable)
Payment Method *
Amount Paid (BDT) *
Your answer
Bank Name, Receipt No. & Date / bKash Ref. No. & Date *
Your answer
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Submit
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