Email Id. : alumni@presidency.edu.inWebsite : www.presidencyalumni.org

Address : CA - 4, H.M.T. Layout, R.T. Nagar, Bangalore - 560 032.

Phone : 98863 7462298450 94444 / 98452 09152

Application Form for Life Membership

“The Association under the name and style of “POSA” – “Presidency Old Students Association” is established with the sole motto to unite the past students of the Presidency schools and Presidency College in the closest bond of good fellowship and fraternity among the alumni and through that process assists the members of the Alumni and the Alma mater to achieve academic and professional excellence. It shall strive to be an umbilical cord between the Alumni, the Presidency Schools, Presidency College, the Management and Faculty”.

Paste your recent

Passport Size Photograph

Please choose the Presidency Institution that you Studied / Graduated:

1. Nandini Layout (Tick Mark)

2. R.T. Nagar (Tick Mark)

3. J.P. Nagar

(Tick Mark)St. Paul's English School

4. College-Hebbal

(Tick Mark)

5. Mangalore (Tick Mark)

6. Bilekahalli (Tick Mark)

7. Kasthuri Nagar (Tick Mark)

8. Yelahanka (Tick Mark)Kempapura

Off Bannerghatta Road

Personal Details (Mandatory):

Full Name:_____________________________________Nick Name : ______________________

Batch (Year of Passing 10th Std./College):_____________Studied upto Class:__________

Date of Birth: ____________________Date of Wedding Anniversary:__________________

Education Qualification:___________________________________________________________

Address for Correspondence:

Permanent: ________________________________

__________________________________________

__________________________________________

__________________________________________

Current: ___________________________________

__________________________________________

__________________________________________

__________________________________________

Landline No. : _______________________________

Mobile No. : _______________________________

Alt. No. (Parents / Siblings) : _____________________________________________________________

Mobile No : _______________________________

Alt. No : _______________________________

Present Occupation:____________________________________________________________________

Office Address:_________________________________________________________________________

_____________________________________________________________________________________

Telephone (Office):________________________Email Id.:_____________________________________

Occupational Details (Optional):

Email Id's : ______________________________________________________________________________

(Estd.1976)

(Estd.1980)

(Estd.1983)

(Estd.2000)

(Estd.2001)

(Estd.2006)

(Estd.2008)

(Estd.2012)

PRESIDENCY OLD STUDENTS ASSOCIATION (POSA)(ALUMNI OF PRESIDENCY GROUP OF INSTITUTIONS)

R

Note : Details to be filled in Block Letters Only.

Let us know in what way you could contribute:

Towards the development of the Institution and Your Juniors:

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Towards the development of Alumni and Society at large:

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Do you have an idea for our Alumni Meet Function - Pattern of programs, which you think

would help put up a good show - If yes, please share it with us:

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Let us know, what you expect from POSA:

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Share any suggestions, which you might have:

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

If you have information about your siblings and batch mates (Juniors/Seniors) passed out

from Presidency Schools/Presidency College, then share it with us to enable us to get in

touch with them:

Sl.No. NameSiblings /Cousins /

Batch mates

Batch(Year of Passing)

Contact No. and

Email Id.

1

2

3

4

5

Payment Details for Life Membership:

To,

The Secretary,"Presidency Old Students Association (POSA)",CA - 4, H.M.T. Layout, R.T. Nagar,Bangalore – 560 032.

Please enroll me as Life Member of the “Presidency Old Students Association” (POSA).

Subscription for Life Membership is being given herewith by:

Life Membership Amount Details:

Registration

Life Membership Contribution

Total Amount

: Rs. 50/-

: Rs. 1,950/-

: Rs. 2,000/-

Declaration:

I, .........................................hereby declare that the details given above are true

to the best of my knowledge and belief. I assure that I will agree to abide by the

Constitution rules and regulations of “Presidency Old Students Association” (POSA)

which are in force at present and amended from time to time. I also assure that I will

keep the office informed about the changes in my Address/Phone Number/Email ID/status,

if any.

Date:_____________ Place: _____________

_____________(Signature)

Cash Cheque DD

Details:...............................................................................

(Tick Mark) (Tick Mark) (Tick Mark)

Signature

Note: Please Mail us the payment details ( UTR / NEFT / DD / CHEQUE / Cash deposits )

Note: Before submitting the form kindly check whether you have given all the information correctly. If there is any change of address and Phone Number in future, kindly inform us by email. The changes will be added in the Alumni Directory.

Submission Procedure :

1. Either scan and e-mail your completed form with a identification of your Address Proof Xerox copy to: alumni@presidency.edu.in

Or

Account Name : “Presidency Old Students Association” (POSA). Current Account No. : 32703156215IFSC Code : SBIN0007982Bank Name : State Bank of India, R.T. Nagar, BangaloreLandmark : Opposite R. T. Nagar Post Office / Above Food World

2. Post your completed form with a identification to:

The Secretary,“Presidency Old Students Association” (POSA), CA - 4, H.M.T. Layout, R.T. Nagar,Bangalore – 560 032.

For further details, please contact the Secretary of POSA.

For Office Use:

Name of the Alumnus:................................................................................

Membership ID No.:.....................Batch:.............Date:.................................

Cash / DD / Cheque No................................ Date.................................

Bank................................ Receipt No....................Date:................................

Remarks:

Verified the above details: Signature of the Secretary

POSA Bank Details: