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PAYYANUR COLLEGE GENERAL ALUMNI ASSOCIATION : MEMBERSHIP FORM
Thank you for your interest in the Payyanur College General Alumni Association. Please duly fill the membership form and submit.
* Indicates required question
Email
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Record my email address with my response
Name
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Your answer
Email ID
Your answer
Year(s) of Study in Payyanur College ( example 1980-85)
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Your answer
Degree studied in Payyanur College ( Select all that apply)
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Pre-Degree (PDC)
B. Sc.
B.A.
B.Com
B.B.A.
M.Sc.
M.A.
Ph.D.
Required
Main Subject (If Applicable)
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Your answer
Educational Qualification
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Your answer
Current Address
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Your answer
Your Profession
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Your answer
Field of Expertise ( For Example Farming, Art, Dance, Literature, Teaching, Scientist.....)
Your answer
Are you a Govt. employee.
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Yes
No
Are you retired
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Yes
No
Not Applicable
Your contact number
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Your answer
WhatsApp number
Your answer
Which type of Alumni Membership would you like to choose?
College will be highly thankful to you if you can take any of the below mentioned memberships by paying the respective fee.
( Membership fee/ donation transaction Account Number 143901000014581, IFSC: IOBA0001439, Indian Overseas Bank, Payyanur)
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Life time Alumni Membership ( 2000 rupees)
Alumni Membership Fee for two Years (500 rupees)
QR Code for the payment of membership fee/Donation
Would you like to offer Donation for ongoing projects like High Tech Seminar Hall and Charity Fund Undertaken by Alumni Association? If yes please mention the amount below and credit the amount to the same bank account given above.
Your answer
Transaction I D
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Your answer
Date of Transaction
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MM
/
DD
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YYYY
Any suggestions?
Your answer
A copy of your responses will be emailed to .
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