2nd GLOBAL GET-TOGETHER OF ALUMNI OF COEP

Date: 19th December, 2009

Venue: College of Engineering, Pune, Campus

Contact Address: Alumni Association of College of Engg., Pune,
Shivajinagar, Pune – 411005.
Email: alumni.coep@gmail.com, info@coepalumni.net
Tel No: 91-020-25541156 / 65003381

Please fill up the information sheet and send it back by email or post on the above address.

INFOSHEET

Name:

Address:



Email:

Tel No.: (O) (R) (Mobile)

Year of Graduation/Post Graduation:

Branch:

Are you member of Alumni Association? Yes No

Life Membership No:

Professional Details: Service/Entrepreneur/Industrialist/Education/Consultancy/________

Organisation:

Designation:

Registration Fee: For single (Alumnus in India) – Rs.1,000/-, For couple – Rs.1,500/-
For single (Alumnus abroad) – $100/-, For couple – $150/-
For COEP faculty – Rs.500/-
For COEP students – Rs.250/-

Mode of Payment: Cheque / Cash / DD

Please pay the cheque in favour of “Alumni Association of COEP” (payable at Pune).



Signature