Alumni Registration Form

     
   
Register your profile to PGOI ALUMNI ASSOCIATION ! The information provided by you will help us to better keep track of our Alumni Group.
   
   
         
  Form No. 161  
  First Name :
 
  Middle Name :  
  Last Name :  
  Gender Male     Female   
  Mobile No.  
  Landline No.  
  Nationality  
  Date of Birth    
  Marital Status  
  Name of Spouse  
  Designation of Spouse  
  Course Completed at PGOI  
  College  
  Year of Joining  
  Year of Passing  
  Current Designation  
  Email Id  
  Current Address with
Contact Details
 
  Organizational Address with
Contact Details
 
  Permanent Address with
Contact Details
 
  Hobby (If any) :
 
         
  Upload Photograph Image size 114x112
 
 
         
      Note : Please don't use SPACE in image name  
       
  Alumni Registration fees
Single Rs 500/-
With spouse Rs. 750/-
By DD in favour of Patel College Of Science & Technology, Bhopal     
Online Payment    
Name of Beneficiary: Patel college of Science & Technology
Bank Name- Punjab National Bank
Branch- MP Nagar
A/c No. 1305002100019921
IFS Code: punb0130500

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  Online Payment : Bank Name
  Online Payment : Transaction Number
  Online Payment : Transaction Date
  Captcha Code