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The Rajkumar College, Dr. Radhakrishnan Road, Rajkot – 360 001 
  The Rajkumar College, Rajkot
Old RkCians' Day - 29th January 2012
ON-LINE REGISTRATION FORM
   
1.
 
Name:*
  (First Name) (Father's Name) (Last Name)
2.
Year of joining RkC:* Year of passing out:*
3.
 
Date of Birth:* 4. Blood Group:*
  DD MM YYYY      
5.
Other relatives who studied in RkC:
Name(s) Year Relationship
6.
Special Achievements while in RkC:
7. Current Profile (including major achievements in life)*:
8.
Family Detalis : (Include name of wife, and children)*
Name(s) Age Relationship
9.
Full Postal Address:*
10.
Contact Details:
Telephone Nos. (Workplace):*
Telephone Nos. (Cell):*
Telephone Nos (Residence):
Email IDs:*
Website (if any):
11.
Any thing in particular that you look forward to on the 29th January 2012.
12.
Total Number of people coming for the event*:
   
  Details of payment
  Note : Registration Fees Rs. 150/= (INR) per person
1.
DD/Cheque No.: drawn on
dated: for Rs. (Rupees only)
2. Will pay by cash upon arrival
   
3. Type in the code in the box given: You must read and type the 6 chars within 0..9 and A..F
   
  * Mandatory Fields
 

 
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