ALUMUNI REGISTRATION FORM

FOR ALL EX-STUDENTS OF KMDC

Kindly fill out the following form to register with KMDC Alumni. Graduates from Karachi
Medical & Dental College (KMDC) are eligible for the registration.

Please fill all the fields, submit the form.




PERSONAL INFORMATION

  • Title:

  • First Name:

  • Last Name:

  • Father’s
    Name:

  • Date of Birth
    (DD/MM/YYYY):

  • Res.Tel No :

  • Gender:

  • Marital Status:

  • Email:

  • Cell. No :

  • Present Address:

ACADEMIC INFORMATION

  • Graduation Year:

  • Qualification Acquired:


  • Postgraduate Qualifications:

  • Awarding Body:

  • Awarding Body:

  • Other Qualification:

EMPLOYMENT

  • Employment:

  • Current Designation:

  • Currently Affiliated:

  • Working Since:

  • Primary Speciliaty:

  • Secondary Speciality:

  • Office Address:

  • Office Phone:

VOLUNTEER

HOW CAN YOU CONTRIBUTE IN THE GROWTH OF KMDC PLEASE SELECT
Yes / No
Can you arrange internships/electives for KMDC students?

Can you mentor students for clinical electives?

Would you be able to guide and/or accommodate kmdcians who travel to your city?
Can you conduct workshop in KMDC/ash in your area of speciality?

Arrange study tours for students of KMDC to your organisation?

Deliver lectures as a guest speaker to share your experience and latests trends?

Join KMDC as a visiting faculty member?

Support /assist alumuni need based scholarship?