CHENABIAN ALUMNI ASSOCIATION MEMBERSHIP FORM

PERSONAL INFORMATION (Please fill the form in capital letters) Mr./Mrs./Ms. Full Name (as per CNIC)

Fathers Name (as per CNIC) Date of Birth (as per CNIC) DD MM E-mail Address YYYY Student of CCJ from YYYY to YYYY Mobile No.(s) Computerized NIC No.
CH

E FO R TW L E S LU MN G E T I AS E NABIA N A S O C I AT O N

Phone No. (Residence) Home Address:

Interest/Hobbies

PROFESSIONAL INFORMATION: Awards

Civic Clubs/Orgnaizations of which you are a member Name of Present Organization you work in Briefly state your kind of job Office Phone No. Office Fax No. Designation

Office Address:

ACADEMIC INFORMATION What degree(s) were attained at CCJ? Name of Hostel/s you resided at CCJ? Names of academic institutions you have been studying Highest degree earned in academic career

Where would you like to receive your mail? Office

Home

P.T.O.

Instruction: 1. All fields are mandatory and should be filled properly. 2.1 Membership/Registration fee for Old Chenabeans residing in Pakistan Rs. 500 (for lifetime) 2.2 Membership/Registration fee for Old Chenabeans residing outside Pakistan $.50 (for lifetime) 3. Please send this form on the following address ATTN: Mr. Liaqat Ali Honorary Secretary (Lecturer at CCJ) Chenabian Alumni Association (CAA) Chenab College Jhang 12-Km Chiniot Road, Jhang (Pakistan) I hereby apply membership for the Chenabian Alumni Association and affirm that the information provided by me is ture to the best of my knowledge and belief I realize that any falsification or misstatement in the said information will make me liable for the disqualification/dismissal from the membership. Bank Draft in favour of Chenabian Alumni Association A/c No.1473-7 from any National Bank drawn on NBP Chenab College Jhang code 1829 as membership fee (Please mention DD No.)

Date __________ For office use only Alumni Code:

Signature__ ________________

Date

Remarks ________________________________________________________________________________________ _______________________________________________________________________________________________ For further information please visit our website www.chenab.edu.pk/caa or e-mail us: E-mail:ca a @chenab.edu.pk