DUVASU Alumni Registration Signup Form

Student Registration Form

Fill out the form carefully for registration
Student Name*

PrefixFirst NameMiddle NameLast Name
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Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student E-mail*
Mobile Number

Area CodePhone Number
Phone Number

Area CodePhone Number
Work Number

Area CodePhone Number
Company
What is your current profession?*
Your current Designation?*
Courses
Entry year in DUVASU*

MonthDayYear
Date
Additional Comments
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