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