Govt.

of Maharashtra
Govt. College of Engineering, Nagpur
Sector- 27, Mihan Rehabilitation Colony New Khapri, Nagpur-441108 (Maharashtra State)
“To be an Institution of National Repute Creating Globally Competent Technocrats to Serve the Society”
% ¼07103½ 295226(P), ¼07103½ 295220 (O)  Website: www.gcoen.ac.in
E-mail: principal.gcoenagpur@dtemaharashtra.gov.in - Office.gcoenagpur@dtemaharashtra.gov.in

ALUMNI REGISTRATION FORM

Batch:
1 ) Name :-
2) Father’s Name :-
3) Date of Birth :-
4) Gender :- Male / Female
5) Branch :-
6) Year of Passing :-
7) Mobile No :-
8) WhatsApp No. :-
9) E-mail ID :-
10) Permanent Address :-
11) Local Address :-
12) Details of Higher Studies, if applicable:
(a) Course Name :-
(b) Specialization :-
(c) University :-
13) Work Information, if Employed :-
(a) Employer :-
(b) Job designation :-
(c) Official E-mail :-
(d) Location :-
14) Details of Competitive Exams, if preparing for:-
(a) Name of the Exam :-
(15) Suggestions for the Alumni Association :-

(16) Are you interested to join Alumni Association Core Committee :- Yes / No
(17) Your Fondest Memory of College :-

Signature of Student