Membership Form

MEMBERSHIP FORM
Alumni Association for students of
Ace Higher secondary School (AASA)
Shouldering social responsibility………..
Personal details
Title (Mr. /Mrs. /Ms.)
First name:___________________________

Last name: ___________________________

Nationality:____________________

District: ____________________

P.P SIZE
PHOTOGRAPH

City: ___________________________
Street address: ________________________________________________________________
____________________________________________________________________________
Contact details
Tel:
Res: _____________________
Office: ___________________
Mob: _____________________
Email: ______________________________________________

IF you were a student
Date of birth: ___________
DD/MM/YY

Permanent Address
__________________________________________________________
__________________________________________________________

Faculty: ____________________
Year started: ________________
Year finished: ________________
Gender:

Subscription
If you would like to keep in touch with AASA by receiving information
about forthcoming activities – seminars, workshops and news stories
please tick the box and make sure you have provided us with your email
address.

M

F

If you were a member of staff
Job title: ______________________
Department: ___________________

Membership type:
General
Lifetime
Honorary

Date of birth: _________________
DD/MM/YY
Start date: _________________
DD/MM/YY
Finish Date: _________________
DD/MM/YY
Gender:

M

F

Career Details
Name of current employer/ organization: _____________________________________________________________
Job title: ____________________________

Address: _______________________________________________

Post code: ___________________________ Work Tel: ____________________

AASA , New Baneshwore, Kathmandu, Nepal.
Tel:
Email:

Fax: ___________________