Membership Form

ALUMNI ASSOCIATION

UNIVERSITY OF AGRICULTURAL SCIENCES

Convention Centre, Hebbal Bangalore - 560024

First Name

Last Name

Father Name

Date of Birth

Affix Photograph
(Instructions: Less than 1MB size is valid)

Preview

Residential Address

Street Street line2

City

State

Postal/Zip

Country

Office Address

Street Street line2

City

State

Postal/Zip

Country

Correspondence Preferred Resident

Email Id

Mobile No.

Alternate Mobile No.

Education

College

Upload Convocation certificate

Course

Year of Passing

Note

1. Life/Associate Membership fee Rs. 500/- +Entrance fee Rs. 10/-
2. Enclose Degree Certificate or Marks Card
3. Enclose two Passport size Photographs

I have read, understood, and accepted the rules for membership