Awards

Enrollment no.*

Name*

Date of Birth*

Degree*

Department*

Branch*

Contact Number*

Email ID*

Permanent Address*

Name, Designation and expected Location in the company / organization / University which you may join after graduating from the institute
(If applicable)

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This information will help us to connect you with regional chapters of IIT Roorkee Alumni Association (IITRAA) present in most of the Tier-1 cities

Your Linkedin URL, if any

Kindly mention the group/activities you have been a part of while in IITR (e.g., sports, hobbies etc.)*

Would you like to become a member of IIT Roorkee Alumni Association (IITRAA)

Yes No

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Benefits of being a member of IITRAA:
1. IITRAA is an association of alumni of IIT Roorkee. Being a member of IITRAA gives you instant entry to the worldwide network of thousands of well-placed IITR alumni.
2. A member can contest for becoming an office bearer of IITRAA.
3. It provides a platform to get associated with local chapters of IITRAA globally.
4. It is a vehicle for networking with IITR alumni for the benefit of alumni and the institute.
5. IITR recommends you to become a member of IITRAA.
(Your library security deposit of Rs. 2000/- will be used for your life membership of IITRAA.)

Your Passport Size Photo*

Your Signature (in Black Ink)*

Would you like to contribute a minimum amount of INR 5000 every year from your annual earning to the alma mater to support the growth of the institute? Donations earned are used for the benefit of students and departments. Donations to IIT Roorkee are 100% exempt from Income Tax as per IT Section 80G.

Yes No

To receive your caution money, please provide your bank account details:

Bank*

A/c No.*

IFSC Code*

Name

Date

(Submit this form online and inform the acknowledgement receipt no. to Accounts Section. Please do not forget to logout from this page.)