CUSB Alumni Association
Registration Form
1. Name *
Your answer
2. Date of Birth *
MM
/
DD
/
YYYY
3. Gender *
4. Marital status *
Required
5. Differently challenged *
Required
6. Social category *
Required
7. Program attended in CUSB *
Required
M.Phil in (If awarded)
Ph. D in (If awarded)
8. Enrolment No.
Your answer
9. Year of Passing *
MM
/
DD
/
YYYY
10. Contact/ Telephone No. *
Your answer
11. Other Contact No. (if any) *
Your answer
12. Email address *
Your answer
13. Social network URL
Your answer
14. Permanent address
Your answer
15. Correspondence address
Your answer
16. Present engagements in service/ education/ entrepreneurship/ social work/ any other activity (Give a brief description)
Your answer
17. Name of organization
(current status)
Your answer
18. Designation
(current status)
Your answer
19. Name of organization
(Past, if any)
Your answer
20. Designation
(Past, if any)
Your answer
21. Achievements/ Awards etc.
Your answer
22. Name, address, designation and contact number of spouse
Your answer
23. Name(s) of children (if any)
Your answer
24. Hobbies
Your answer
25. Place
Your answer
Submit
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