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  • Student ECell Member Sign-Up Form Edited March 2011

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    nivedita_h42404
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    This document is a registration form for student membership in NEN (National Entrepreneurship Network). It requests basic contact and enrollment information from students, including name, gender, date of birth, institute and course details, contact information, and preferred sign-up options for the NEN website, community portal, and event/communication updates. Students must submit the completed form to their faculty leader or NEN consultant to receive membership benefits.

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    Student ECell Member Sign-Up Form Edited March 2011 (2)

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    This document is a registration form for student membership in NEN (National Entrepreneurship Network). It requests basic contact and enrollment information from students, including name, gender, date of birth, institute and course details, contact information, and preferred sign-up options for the NEN website, community portal, and event/communication updates. Students must submit the completed form to their faculty leader or NEN consultant to receive membership benefits.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    3 views1 page

    Student ECell Member Sign-Up Form Edited March 2011

    Uploaded by

    nivedita_h42404
    This document is a registration form for student membership in NEN (National Entrepreneurship Network). It requests basic contact and enrollment information from students, including name, gender, date of birth, institute and course details, contact information, and preferred sign-up options for the NEN website, community portal, and event/communication updates. Students must submit the completed form to their faculty leader or NEN consultant to receive membership benefits.

    Copyright:

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    of 1

    NEN STUDENT MEMBERSHIP REGISTRATION FORM

    Please fill in BLOCK letters


    All details are mandatory to receive NEN membership benefits
    Please hand over/email the completed form to your coordinating Faculty Leader or the NEN Consultant at your campus

    GENERAL INFORMATION
    First Name: Mr. / Ms. _________________________________ Last Name:______________________________________
    Gender

    Date of Birth (DD/MM/YYYY):___________________________

    Institute Name & City :_________________________________________________________________________________


    * (Please mention your institute name completely and avoid abbreviation)

    Your Designation at the E-Cell:______________________________________________________________________


    (E.g.: E-Member / E-Leader)

    Current Degree/ Course discipline:______________________________Current year of study: ______________________


    (E.g. BA/BE/B.Com/MBA)

    (E.g. 1st, 2nd year)

    Year & Month of passing out in the present course: Month _____________________ Year ____________________
    (E.g. June, 2011)

    CONTACTINFORMATION:(Willbekeptconfidential)
    Mobile No:_________________________________________ Landline No: ______________________________________
    *(Providing any one is compulsory)

    Permanent E-Mail ID: __________________________________Alternative E-Mail ID: _____________________________


    *(Providing any one is compulsory)

    Permanent Home Address: ______________________________________________________________________________


    City ________________________State ____________________________Pin code __________________

    SIGN-UP OPTIONS
    I want to sign up for: (Please tick where applicable)
    NEN Online (Website)
    NEN 360 (Community Portal) and have my own profile page created by the NEN Communications Team
    (Note: If you select this option, your NEN 360 login details will be e-mailed to the address provided in this form)

    NEN event and communication updates via e-mail


    Signed:
    Date (DD/MM/YYYY):

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