IIPM

Alumni Registration Form

*Name of the Alumni:

Personal Details

*Date Of Birth:

*Father’s Name:

*Mother’s Name:

* Permanent Address:

Present Address:

Land Line Number:

* Mobile Number:

* E-Mail ID:

Academic Details

Course Studied :

*Year of Admission:

*Year of Passing:

Employment Details

Service Business (Self Employed) Unemployed

* Designation:

* Company:

*Office Address:

*Land Line Number:

*E-Mail Id:

Website:

*Additional Information / Testimonials / Comments / Suggestions(IF ANY):

Register Yourself