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Online Membership Registration

APPLICATION FORM

JAPANESE UNIVERSITIES ALUMNI ASSOCIATION IN BANGLADESH (JUAAB)

APPLICATION FORM FOR MEMBERSHIP

Personal Details:

Name (in Block Letters)
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Photo Upload
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Passport size Photo

Father’s / Husband’s Name
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Mailing Address
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Date of Birth (D/M/Y)
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Present Occupation with Designation
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Contact Cell Number:
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Details of Education in Japan

Type of Scholarship / Source of Funding

University / Institute / College Graduated and/or Attended

(a) Name
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(b) Period
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(c) Degree Obtained
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Declaration
I do herby declare that I shall abide by the rules and regulations of the Association.

Signature of the Applicant
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Signature
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Signature Date
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(a) Type of Membership:
(i) General Member/ (ii) Life Member/ (iii) Associate Member(b) Subscription Received (i) Tk.500+200/ (ii) Tk.5000 (iii) Tk.200+100


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