Kalinga Samaja Membership Registraion

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1.Your Full Name? *

2.Your department? *

3.Your position? *

BTech student

MTech student

MS student

Research scholar

Staff

Faculty

Other:

4.In case of students; you are now in which year of your study?

1st

2nd

3rd

4th

5th

Clear selection

5.Your Roll No/ EC NO? *

6.Your Mail Id *

7.Your Hall and Room No/ Qtr No? *

8. Given the membership fee? *

BTech-Rs 250/-, Master degree: Rs 350/-, Research Scholars/Staff Rs 500/-, Faculty: Rs 1000/-

Yes

9. If membership fee is given, your receipt no?, If No, reason?

10.You are from which place of Odisha?

(This is required to get some information from different parts of Odisha, when needed)

11. Your hobby?

12. Any suggestion for Kalinga samaja development?

Submit

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