MMIHS Alumni Association

Soalteemode, Kathmandu

Phone: 01-5908745/46/47/48 | Fax: 01-5908749

Registration Form

Basic Information

Program *

Pass Year *

Name (English - Block Letters) *

Name (Devanagari) *

Member Type *

Gender *

Permanent Address

Province *

District *

Local Level *

Ward No *

Temporary Address (Optional)

Same as Permanent Address

Province

District

Local Level

Ward No

Personal Details

Date of Birth (BS) *

Format: YYYY-MM-DD (BS)

Date of Birth (AD) *

Format: YYYY-MM-DD (AD)

Blood Group

Contact Information

Email Address *

Mobile *

Telephone

Working Information (Optional)

Working Place Name

Position

Working Date From

Format: YYYY-MM-DD (BS)

Working Date To

Format: YYYY-MM-DD (BS)

Abroad Address (if any)

Family Information

Father's Name *

Father's Email

Father's Mobile

Mother's Name *

Mother's Email

Mother's Mobile

Photo of Alumni Student *

Accepted formats: JPG, PNG, GIF (Max: 2MB)

Declaration: I hereby declare that the information given in this application form is true and agree to abide the rules and regulations of MMIHS Alumni Association. Note: Once submitted, this form cannot be edited.

Important: Please scan the QR code and complete the payment before submitting the form.
Only paid and verified entries will be approved.

Payment Screenshot *

Upload screenshot of payment confirmation (JPG, PNG, GIF - Max: 2MB)

Quick Access

MMIHS Alumni Association

Registration Form

Basic Information

Permanent Address

Temporary Address (Optional)

Personal Details

Contact Information

Working Information (Optional)

Family Information