JAPANESE UNIVERSITIES ALUMNI ASSOCIATION IN BANGLADESH (JUAAB)
ONLINE APPLICATION FORM FOR MEMBERSHIP

1. Personal Details:
1.	Name (in Block Letters):
	Father's / Husband's Name:
2.	Mailing Address:
	Telephone:
	Fax:
	Email:
3.	Date of Birth:			Day/	Month	/Year
4.	Present Occupation:
	Designation:
2. Details of Education in Japan:
1.	Type of Scholarship/Source of funding:
2.	University/Institute/College Graduated and/or Attended:
	(i)	Name:
	(ii)	Period:
	(iii)	Degree Obtained:
3.	I do hereby delcare that I shall abide by the rules and regulation of the Association