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Annamalai University Alumni Association (AUAA)

ALUMNI MEMBERSHIP REGISTRATION FORM

Name :
Father's Name :
Gender : Male :   Female :
Date of Birth : [eg. 20/06/1999]
Year of Education : From: To
Faculty :
Department :
Occupation :
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Designation with Official Address :
Designation :
Organization :
City :
District :
State :
Country :
PIN :
Phone No. with STD Code :
Address for Correspondence :
Street :
Village :
City :
District :
State :
PIN :
Country :
Phone No. with STD Code :
Mobile :
Email ID :
Membership fees details :
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Submit the registration form with necessary enclosures to
The General Secretary
Annamalai University Alumni Association
Hall No. 3214, Platinum Jubilee Building
Faculty of Engineering & Technology Campus
Annamalai University
Annamalainagar – 608 002
India.
email: auaassociation@gmail.com
Mobile No: 9443414104.