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Alumni Registration Form
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Name
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Your answer
Age
*
Your answer
Sex
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Male
Female
Date of Birth
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MM
/
DD
/
YYYY
Marital Status
*
Married
Unmarried
Course attended at NISH
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BASLP
MASLP
Bachelor of Fine Arts (HI)
BSc (Computer Science)(HI)
DTY DHH/ DTY(HI)/ DECSE
DSS (Diploma in Software Systems
DSE( Diploma in Special Education)
Others
Batch
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If you are working (fill in the following details):
Current Organization
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Organizational address
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Job Title
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Current Location
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Work experience (Years)
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0
1
2
3
4
5 and more than 5 years
City
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Pincode
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State
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Country
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Permanent Address
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House Name
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Address
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City
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Pincode
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State
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Country
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Landline Number
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Mobile Number
*
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Email ID regularly used
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Any Experiences that you would like to share during the alumni meet please mention below
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Do you want someone to tell your experience
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No
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Hobbies
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Social Networking sites
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Please mention the social networking sites you are available
Facebook
Twitter
Linkedln
Google plus
Flickr
Pinterest
whatsapp
Option 8
Preferred mode of contact
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SMS
E-Mail
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Comments, Suggestions and Ideas
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Is anyone accompanying you?
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No
If anyone accompanying please mention how many
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1
2
3
4
5
Membership/ Registration Details
Registration fees is Rs. 300 only. If anyone accompanies additional amount of Rs.100 will be charged.
Alumni Lifetime membership fee is Rs 300/-
Do you wish to seek lifemembership
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Yes
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