DORA Office Proforma for No Dues

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DORA Office IIT Roorkee

Proforma to establish active association with the Alma Mater

(This form is to be submitted to obtain the No Dues)

Enrollment no.*

Name*

Degree*

Date of Birth*

Bhawan*

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)

This information will help us to connect you with the IITR alumni near your location.

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 donate your library security deposit of Rs. 2000/- to support any of the campus groups, entities or activities? If yes, please select.

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 latest bank account details:

Bank*

A/c No.*

IFSC Code*

Name

Date