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MITS ALUMNI ASSOCIATION, DELHI – MEMBERSHIP FORM

 

 

 

To,

 
MITS Alumni Association,
610, Maitri Apartment, Plot No.17,
Sector 10, Dwarka, NEW DELHI 110075. INDIA
 

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Printable FORM
I wish to register as member of the MITS AlumniAssociation, Delhi Chapter as per the details given hereunder:
(Please fill all the details in CAPITAL Letters. Fields marked with * are mandatory)
Name *  
Batch (Year of Passing) *  
(Course / Branch) *  
Mobile *  
Email *  
OCCUPATION
Position Held / Designation organization
Office Address City
Telephone:(STD Code-PhoneNo.) Office pincode
PERSONAL DETAILS
Residence Address City(Res)
Telephone:(STD Code-PhoneNo.) Res pincode
Date of Birth(DD-MM-YYYY) Date of Marriage(DD-MM-YYYY)
FAMILY DETAILS
Spouse Name Children Name(s)
PAYMENT DETAILS
 

Please Choose PAYMENT MODE(ONLINE OR OFFLINE)

Registration Fee: Rs. 500/–Life Membership Fees: Rs. 2000/- (To be paid along with registration) Total Rs. 2,500/-

 

 

ONLINE PAYMENT:

ONLINE

We are presently using PayUMoney for cost advantages.You will need to sign in with PayUMoney to use this facility.
OFFLINE PAYMENT:
  1. Cheque: If you want to pay by cheque/DD, same shall be made in favour of ?MITS Alumni Association, Delhi? payable at New Delhi to be sent at following address:
    Mr. Kamal Singhi
    MITS Alumni Association 610,Maitri Apartment,Plot No. 17,Sector-10,Dwarka,New Delhi-110075
  2. If you want to credit the payment directly in the account/through NEFT/RTGS etc., the relevant details are as under:
    Name of the beneficiary account holder: MITS Alumni Association
    Saving Account No.: 000701264760
    Bank Name: ICICI Bank, Phelps Building, Inner Circle Connaught Place, New Delhi-01
    IFSC: ICIC0000007
    MICR: 110229002

OFFLINE

Payee Bank Name Payment Amount
Cheque Number Transaction Details(if done through IFSC)

 

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