Udai Pratap Autonomous College (Varanasi)

ALUMNI REGISTRATION FORM

*Fields marked with () are Mandatory**
Enrollment No *
Alumni Name *
User Name (Email Address) *
Password *
Confirm Password *
Sex *
Date of Birth *
Year of Passing *
Class *	(Please mention class at the time of leaving school)
Mobile No *
Address
If you are studying (fill in the following details)
Current Institution
Current Course being Pursued
Currently Studying in the Year/Semester
Current Location
Specialization / Major
If you are working ( fill in the following details)
Current Organisation
Current Designation
Current Location
Highest Qualification Held
Specialization / Major
Institute
Memorable Incident at School	(not exceeding 100 words)
About Me	(not exceeding 100 words)
Social Media	click here to Add
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I agree to all the terms and conditions of the association.

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