Usha Rama Alumni

Certificate of Registration

Name* :
Father's Name :
Department/Program* :
Course & Branch* :
Regd No / Hall ticket No* :
Year of study* :
Address for Communication (Permanent)* :
Email id* :

Get verification code by submitting your mail id.
Verification Code* :
Mobile* :
Name & Phone nos of 5 best friends in your class :
Hobbies :
Academic Achievements :
Awards achieved :
Placement details* :
Job details with address :
Future plans* :
Signature of Student* :
Recent color photo (Image dimensions 2" x 2") : Upload Bitmap / jpeg / gif / png formats only. Size below 2MB