Your name

Father's name

Branch

Year of Passing

Date of Birth

Date of Marriage Anniversary

Faculty Member
—Please choose an option—YesNo

Present Designation/Last Designation, if retired

Name of Organization

Office/Business Address

Your email

Mobile/Phone Number

Residential Address

Type of Membership
—Please choose an option—Life Membership (Rs 5000/-)Annual Membership (Rs 1000/-)

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The A/C payee Draft/cheque may be drawn in favour of "The Benares Alumni Association of IIT(BHU)" and may be sent either to Shri Kunwar Vyomesh, Secretary (094152244762) or Sir Nitin Malhotra, Treasurer (09839057559) for the Registration Fees.

The registration fee may be directly transferred to :
THE BENARES ALUMNI ASSOCIATION OF IIT(BHU ), SAVINGS A/C NO. 031001008317, IFSC ICIC0000310
MICR 221229003 , ICICI BANK, SIGRA, VARANASI

The screenshot may be shared with the Secretary/Treasurer as above.