Department of Accounting and Information Systems

Rajshahi University Accounting Alumni Association Department of Accounting and Information Systems University of Rajshahi, Rajshahi 6205, Bangladesh Passport size photograph

Membership Registration Form

1. Name: Title:  Mr  Ms  Dr  Prof

2. Degree obtained  Bachelor Year:  MPhil , Year: from Accounting  Masters Year:  PhD , Year: Department 4. Mailing address: ......

...... District: ...... Post code: ......

e-mail: ...... Tel / Cell: ...... 5. Permanent address: ......

...... Post code: ...... District: ...... 6. Occupation: Designation (if any): 7. Name of spouse: No. of children: Son(s): Daughter(s):

8. Category of  Member  Life-member  Golden Member  Distinguished Donor Member Membership**:  Grand Donor Member 8. Amount payable**:  Tk: ( in words); ...... thousand only.

9. Mode of payment: Bank deposit  Cheque Online transfer, ref. no.: ...... date: ...... / .. .., ...... Bank, Branch ......

Signature Date: * Please attach photocopy of any academic certificate obtained from Rajshahi University. Subscription should be payable to: Rajshahi University Accounting Alumni Association, S/B ac no.: 0200009737733 Routing No. 010812112 Agrani Bank Ltd, Rajshahi University Branch.

↓ ...... a p p l i c a n t ‘s p a r t ...... a p p l i c a n t ‘s p a r t ...... ↓

**Registration information: There will be the following categories of member: 1) Member: Two years subscription for a member is Tk 1,000.oo ( Taka One thousand). 2) Life-Member: Donation for a Life-Member is Tk 5,000.oo (Taka Five thousand). A non-alumnus with this amount of donation will be an Associate Life-Member. 3) Golden Member: Donation for a Golden Member is Tk 25,000.oo (Taka Twenty five thousand). A non-alumnus with this amount of donation will be an Associate Golden Member. 4) Distinguished Donor Member: Donation for a Distinguished Donor Member will be Tk. 50,000.oo (Taka Fifty thousand). A non-alumnus with this amount of donation will be an Associate Distinguished Donor Member. 5) Grand Donor Member: Donation for a Grand Donor member will be Tk. 1, 00,000.oo (Taka One lac). Name with address of a Grand Donor Member will be displayed on a wall-plaque in the proposed Alumni Gallery. A non-alumnus with this amount of donation will be an Associate Grand Donor Member.

Please contact for Registration and Information: Tel.: +880 721 711133, + +880 721 711651  Fax: +880 721 750064 (atten: Sub Committee)  Cellular: +880 1717 743984 email: [email protected]  website: www.ru.ac.bd/Accounting Received with thanks from: ...... the amount:  Tk: ......

( in words); ...... thousand only. Date: ...... for RUAAA