Registration Form

Registration Form

CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : ISWARA MOHARANA Present Address : AT/PO-MADHABANDHA VIA-CHIKTI, DIST-GANJAM, ODISHA-761010 Permanent Address : AT/PO-MADHABANDHA VIA-CHIKTI, DIST-GANJAM, ODISHA-761010 Occupation/Profession : PRESS REPORTER Year of Graduation : 1996 Contact No.(Cell No):1 9439212047 2 7381995849 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : DIBAKAR PANDA Present Address : AT-NUAMAISANPUR PO-MAISANPUR, VIA-PATRAPUR DIST-GANJAM, ODISHA-761004 Permanent Address : AT-NUAMAISANPUR PO-MAISANPUR, VIA-PATRAPUR DIST-GANJAM, ODISHA-761004 Occupation/Profession : LECTURE IN EDUCATION,D.S.J R MAHAVIDYALAYA, KHARIAGUDA Year of Graduation : 1999-2001 Contact No.(Cell No):1 9437109075 2 9861166120 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : UMASHANKAR PRADHAN Present Address : DECAN JUNIOR COLLEGE AT/PO-HILPATTNA, BERHAMPUR (GM Permanent Address : AT/PO-TINIGHARIA VIA-KHARIAGUDA, PS-JARADA DIST-GANJAM (ODISHA) Occupation/Profession : LECTURE IN EDUCATION Year of Graduation : 1998-2000 Contact No.(Cell No):1 +91-9178860945 2 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : DURYADHAN PRADHAN Present Address : AT/PO-KARAPADA VIA-BAMAKOYI, DIST-GANJAM,PIN-761042 Permanent Address : AT/PO-KARAPADA VIA-BAMAKOYI, DIST-GANJAM,PIN-761042 Occupation/Profession : LECTURE IN EDUCATION Year of Graduation : 1998 Contact No.(Cell No):1 9937816668 2 E-Mail Address : Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : KABACHA KAMAKSHI PRASAD BRAHMA Present Address : HIGH SCHOOL STREET, CHIKITI GADA, GANJAM ODISHA Permanent Address : HIGH SCHOOL STREET, CHIKITI GADA, GANJAM ODISHA Occupation/Profession : REALISTIC Year of Graduation : 1999 Contact No.(Cell No):1 8099836456 2 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : SUDAM PRADHAN Present Address : SHAKTI NAGAR 1ST LANE, GOSANI NUAGAM, BERHAMPUR Permanent Address : AT/PO-KELUA, VIA-PATRAPUR,DIST- GANJAM, ODISHA, Occupation/Profession : TEACHER (HINDI) Year of Graduation : 1998 Contact No.(Cell No):1 9437670766 2 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : LAXMI NARAYAN NAYAK Present Address : AT-CHUDALINI, PO-SAMANTIAPALI, DIST-GANJAM, -761004 Permanent Address : AT/PO-BHIMPUR,VIA-PATRAPUR,DIST- GANJAM, ODISHA, Occupation/Profession : BUSINESS Year of Graduation : 1998 Contact No.(Cell No):1 9439258548 2 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : SANATANA PRADHAN Present Address : AT/PO-KHARANIPADA, VIA-SURANGI, DIST-GANJAM, ODISHA, 761037 Permanent Address : AT/PO-KHARANIPADA, VIA- SURANGI,DIST-GANJAM,ODISHA,761037 Occupation/Profession : TEACHERSHIP, CRCC-NUAPENTHO Year of Graduation : 1996 Contact No.(Cell No):1 9438450137 2 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : SUSHILA KUMAR PANIGRAHY Present Address : AT/PO-MUNDAPOTA, VIA- BAMAKOI,DIST-GANJAM, ODIHA,-761042 Permanent Address : AT/PO-MUNDAPOTA, VIA- BAMAKOI,DIST-GANJAM, ODIHA,-761042 Occupation/Profession : LECTURE IN ECONOMICS Year of Graduation : 1996 Contact No.(Cell No):1 9437885464 2 E-Mail Address : Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : MOHAN KUMAR SAHU Present Address : AT/PO-CHIKITI PENTHO,BRAHMA NAGAR, DIST-GANJAM Permanent Address : AT/PO-CHIKITI PENTHO,BRAHMA NAGAR, DIST-GANJAM Occupation/Profession : LECTURE IN IRPM Year of Graduation : 1990 Contact No.(Cell No):1 9938022455 2 E-Mail Address : Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : NARAYANA PRADHAN Present Address : AT/PO-BAMAKOYI, DIST-GANJAM, ODISHA, 761042 Permanent Address : AT/PO- BAMAKOYI, DIST-GANJAM, ODISHA, 761042 Occupation/Profession : DEMONSTRATOR IN EDUCATION Year of Graduation : 1997 Contact No.(Cell No):1 9937348097 2 7788925656 E-Mail Address : Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : PRAHALAD GOUDA Present Address : CHIKITI PENTHO, PADMA NAGAR, Permanent Address : CHIKITI PENTHO, PADMA NAGAR, Occupation/Profession : BUSINESS Year of Graduation : 2000 Contact No.(Cell No):1 8457975021 2 9438862249 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : G NANDESU Present Address : QTR.NO-C-23/4A, OFFICERS COLONY.PO- MTPS, DVC, DURLAVPUR, BANKURA(W.B)-722183 Permanent Address : AT/PO-MAISANPUR, VIA-PATRAPUR, DIST-GANJAM, (ODISHA)761004 Occupation/Profession : DY, MANAGER (HR) DVC Year of Graduation : 2001-2004 Contact No.(Cell No):1 9531757904 2 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : P JAYA PRAKASH SUBUDHI Present Address : A/P-CHIKITI PENTHO, MAIN ROAD Permanent Address : A/P-CHIKITI PENTHO, MAIN ROAD Occupation/Profession : BUSINESS Year of Graduation : 1994 Contact No.(Cell No):1 9937077838 2 9840477838 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : KRUSHNA MAJHI Present Address : AT-JHAGADA, PO-RAMACHANDRAPUR, PS-K NUAGAM Permanent Address : AT-JHAGADA, PO-RAMACHANDRAPUR, PS-K NUAGAM Occupation/Profession : BUSINESS Year of Graduation : 2013 Contact No.(Cell No):1 7873732143 2 E-Mail Address : Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : SANJAYA KUMAR PADHY Present Address : AT/PO-CHIKITI GADA,PS-K NUAGAM, DIST-GANJAM Permanent Address : AT/PO-CHIKITI GADA,PS-K NUAGAM, DIST-GANJAM Occupation/Profession : BUSINESS Year of Graduation : 1998 Contact No.(Cell No):1 9439261194 2 985338470 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : L VENKET PATRO Present Address : CHIKTI PENTHO, CHIKITI, GANJAM,- 761010 Permanent Address : CHIKTI PENTHO, CHIKITI, GANJAM,- 761010 Occupation/Profession : BED COMPLET Year of Graduation : 2012 Contact No.(Cell No):1 9776550031 2 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : MUKESH PADHY Present Address : AT-SATYA NAGR, KARABALUA,PO- CHIKITI PENTHO,DIST-GANJAM, PIN-761010 Permanent Address : AT-SATYA NAGR, KARABALUA,PO- CHIKITI PENTHO,DIST-GANJAM, PIN-761010 Occupation/Profession : STUDENT Year of Graduation : 2013 Contact No.(Cell No):1 8984494298 2 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : RADHAKANTA PADHY Present Address : AT/PO-MAISANPUR,PS-K NUAGAM,DIST- GANJAM,PIN-761004 Permanent Address : AT/PO-MAISANPUR,PS-K NUAGAM,DIST- GANJAM,PIN-761004 Occupation/Profession : LECTURE IN POLITICAL SCIENCE, CHIKITI MAHAVIDYALAYA, CHIKITI, Year of Graduation : 2013 Contact No.(Cell No):1 8093175253 2 7205227152 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : ALEKHA CHANDRA SETHI Present Address : AT/PO-KRUSHNAPUR, VIA-CHIKITI, DIST-GANJAM,PS- K NUAGAM, Permanent Address : AT/PO-KRUSHNAPUR, VIA-CHIKITI, DIST-GANJAM,PS- K NUAGAM, Occupation/Profession : LECTURE IN EDUCATION DEPT, Year of Graduation : 2013 Contact No.(Cell No):1 9178287089 2 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : DIBAKARA PANIGRAHY Present Address : AT/PO-CHIKITI PENTHO, DIST-GANJAM, ODISHA, PIN-761010 Permanent Address : AT/PO-CHIKITI PENTHO, DIST-GANJAM, ODISHA, PIN-761010 Occupation/Profession : LECTURE IN CHEMISTRY, Year of Graduation : 2008-2011 Contact No.(Cell No):1 9778729803 2 E-Mail Address : [email protected] Signature of the Participant CHIKITI MAHAVIDYALAYA, CHIKITI, GANJAM ALUMNI MEET ON 20-12-2015 REGISTRATION FORM Name of the Participant : K BHAIRAB SUBUDHI Present Address : CHIKITI PENTHO, GANJAM(ODISHA) Permanent Address : CHIKITI PENTHO, MAINROAD Occupation/Profession : BUSINESS, Year of Graduation : 1983-85 Contact

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