Dr. Ambedkar College, Nagpur

Alumni Registration Form

Regd. No. or Unique ID on your college I-Card, if available

Year of Joining *

Course *

Date of Birth *

Personal Details

Your Photograph

Digital Photograph should be in JPG format and less than 100KB

First Name *

Middle Name

Last Name *

Email *

Mobile No *

Current address *

Country *

Higher Education Details

Higher Studies pursued after
leaving DACN UG/PG/PH.D.
Course, please specify

Specialization

Area of Research

Name of the Institution

Name of the Country

Research Details

Research

Specialization

Area of Research

Name of the Institution

Name of the Country

Present Working Details

Placement Provided by DACN ?

Present Organization *

Current Position/Designation *

Previous Working Details

Previous Organizations

Previous Positions/Designation

Experience Summary Previous Organizations

Other Details

Technology Expertise:

Domain Knowledge:

How would you like to contribute towards DACN?

For Delevering Guest Lecture
As a Resource person for Conferences and Workshops
As a Mentor
As a Evaluator of teaching Learning Process
Support in Internships and Placements
Support in R&D Activities
As a Donor

When can you visit our Campus (Tentative Dates):

Your Suggestions :

Any other Information:

Param Poojya Dr. Babasaheb Ambedkar Smarak Samiti's

Dr. Ambedkar College

Deeksha Bhoomi, Nagpur

: 0712-2955785, : info@dacn.in