Annamalai University Alumni Association (AUAA)
Reg. No. 1/2015

AUAA MEMBERSHIP APPLICATION FORM

Title :*
Full Name with Initial (in CAPITAL Letters) :*
Last Name/ Expansion of Initial/ Father's Name :*
Gender :* Male :   Female :
Date of Birth :* [eg. 20/06/1999]
Year of completion of first degree in Annamalai University:*
(If not graduated from Annamalai University, year of joining in the University)		   Highest Degree Obtained:*
Faculty :*
Department :*
Present Occupation :*
ID Proof :*    No.:  
Upload latest passport size photo :   Allowed image types: jpg, jpeg
Designation with Official Address :
Designation :*
Organization :*
City :*
District :*
State :*
Country :*
PIN :  
Phone No. with STD Code :  
Address for Correspondence :
Address Line 1 :*
Address Line 2 :  
Address Line 3 :  
City :*
District :*
State :*
PIN :*
Country :*
Phone No. with STD Code :  
Mobile :*
Email ID :*
Membership type and fee details :*
Introduced by (Name) :       Life Membership No :
Upload Degree / Diploma / Certificate copy :   Allowed image types: jpg, jpeg
* Mandatory fields  
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