Member Registration

REGISTRATION

Member Registration Form

Join the Alumni Association of AMCC

Membership Fee & Account Details

Membership fee Rs.1,500.00 (Annual fee [Rs. 500.00] + Admission fee [Rs. 1,000.00]) Lifetime membership fee Rs. 5,000.00

Acc. Details

Acc. No: 017200150025949

Name: OB & OG Association Balangoda A. M. N. C.

Bank: People's Bank

Branch: Balangoda

Note

සාමාජික ගාස්තුව බැංකුවෙහි තැම්පත් කිරීමේදී ලැබෙන තැම්පතු පත්‍රයේ ඡායාරූපයක් හෝ මාර්ගගතව ගෙවීම් සිදුකිරීමේදී ලැබෙන තහවුරු පත්‍රය තේරීමෙන් පසු සාමාජික දත්ත පිරවීමට අදාල ෆෝරමය දර්ශනය වේ

Select the bank deposit slip or online transaction related slip to proceed to the member details filling form

Membership Payment

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Personal Information

Title *

Initials *

First Name *

Last Name *

Date of Birth *

Gender *

NIC / Passport No. *

Contact & Address

Contact No. (Primary) *

Contact No. (Secondary)

WhatsApp No.

Email Address *

Residential Address

Address Line 1 *

Address Line 2

Address Line 3

Country *

Postal Code

Academic & Professional

Index No.

School Duration (From) *

School Duration (To) *

GCE O/L Year

GCE A/L Year

Leaving Certificate *

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Professional Details

Current Designation

Work Place / Business

Children Details

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Other Information

Additional Notes

Declaration of Accuracy I hereby declare that all the information provided in this registration form is true, complete, and correct to the best of my knowledge. I understand that any false information may result in the rejection of my membership.

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