DUHS DIRECTORY
OF
DOW UNIVERSITY ALUMNI (DUA)
(For all ex-students of Dow Medical College, Sindh Medical College & Other DUHS Institutes / Colleges)
ALUMNI REGISTRATION FORM


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Photograph should be Scanned and email at dua@duhs.edu.pk separately with Name & Form No. / Enrollment No.
Please fill all the fields, and submit the form
Personal Information
First Name:
Middle Name:
Last Name:
Gender:
Marital Status:
Date of Birth (yyyy-mm-dd): e.g (1983-03-25)
CNIC/NICOP No:
Cell No. (With Code)
Res. Tel No.
Fax No.
E-Mail
Skype ID
Overseas Phone # No (if any)
Present Address
Permanent Address
Academic Information
College / Institute:
Year of Graduation (e.g 2009)
Qualifications Acquired
Mention Institute / University of Postgraduate Degree
Speciality
If Undertraining for any course, mention details
Date of course completion (yyyy-mm-dd): e.g (2012-03-25)
Employment
Employment
Present Designation:
Job Description
Working Since:
Office Tel. No.
E-Mail (if diff.)
OPTIONAL Information (Not to be Published in DUHS Directory) for social interaction with Alumni family members
Spouse Details:
Name
Education
Institute / College
Speciality
E-Mail
Post Graduation (if any)
Worked after education
Children information:
Name & Age Education Profession
(at Present or to be)
1
2
3
4
Information Only for DUHS Administration
NOT for DUHS Directory publication
Previous Work Experience(To Plan CME & CPD Programs)
Work Performed after graduation (Mention nature of job and its duration)
Job Title Duration
1
2
3
4
How can you contribute in the growth of the university:
Arranging Internship/Electives ?
Developing linkage for DUHS with your organization ?
Conduct workshop at DUHS in your area of specialty ?
Arranging study tours for students of DUHS to your organization ?
Delivering lectures as a GUEST SPEAKER to share your experience and latest trends of markets ?
Join DUHS as Visiting Faculty member ?
Job Placement ?
Support / assist Alumni need based Scholarship ?
NOTE: The DUHS Directory will be published in August 2011 and the data submitted by 30th July alongwith colour photograph will be published. The copy of directory can be obtained from DUHS. It will also be published on DUHS website.
Request: Please also inform your class fellows and other DMC & SMC Graduates regarding this online form.
For queries contact on email: dua@duhs.edu.pk