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| Alumni Registration Form |
| Please, fill in the following details in order to receive your USERNAME and PASSWORD and become a member of ESEI Alumni Association.
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Personal Details
| Name (*):
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Surname (*):
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Matriculation Year (*):
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| Gender:
Male
Female |
Date of birth:
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| Nationality
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Current Address :
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City/Postal code
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Home Phone:
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Business Phone:
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Mobile Phone:
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e-Mail (*):
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| Academics
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| Degrees obtained:
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Are you currently employed?
Yes
No
Self-employed
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| Current occupation |
| Place of work/Employer |
| Country
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| Web Page |
Can we list you in the Alumni Email Registry?
Yes
No
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| Is there any news or comments you would like to add?
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Are you interested in receiving:
ESEI Newspaper?
Yes
No
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invitations to ESEI/Alumni events?
Yes
No
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