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Registration Form
  Alumni
 
ALUMNI REGISTRATION
     
* Name
:
* Sex
:
Male   Female
* Date of Birth
:
  Details of your stay at PBSIDDHRTHA
Course of
study
Program Roll No Group Subject(s) Year of Admission Year of Completion
Inter
Degree
PG
  Present Occupation
 
  Name of the Orgnization
:
* Working Address
:
* Permanent Address:
:
* Contact Numbers:
:
Mobile      Land Line 
   Facebook/BlogID
:
  Any suggestions to your alma mater
:
 
  * E-mail ID/User Id
:
  * Password
:
  * Confirm Password
:
  Upload Passport Size Photograph
  (below 100 KB)
:
uploaded image preview
 
 
 
  
 
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