Name*

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Pan No*

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Mobile*

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City*

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Email Id*

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Well-wisher(Non IITian)1960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026Year of Passing*

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AnushrutiLife membership feeEvent RegistrationDonationRoorkee ChapterBatch 1970Batch 1971Batch 1972Batch 1973Batch 1974Batch 1975Batch 1976Batch 1977Batch 1978Batch 1979Batch 1980Batch 1981Batch 1982Batch 1983Batch 1984Batch 1985Batch 1986Batch 1987Batch 1988Batch 1989Batch 1990Batch 1991Batch 1992Batch 1993Batch 1994Batch 1995Batch 1996Batch 1997Batch 1998Batch 1999Batch 2000Batch 2001Batch 2002Batch 2003Batch 2004Batch 2005Batch 2006Batch 2007Batch 2008Batch 2009Batch 2010Batch 2011Batch 2012Batch 2013Batch 2014Batch 2015Batch 2016Batch 2017Batch 2018Batch 2019Batch 2020Batch 2021Batch 2022Batch 2023Batch 2024Batch 2025Batch 2026Purpose

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Degree / Branch

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Remarks

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Amount*

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Credit CardDebit CardNet BankingUPIPayment Mode*

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Proceed