Virtual Alumni Reunion – School of Nursing and Midwifery (PK) – 10 Oct 2020

Registration Form

Kindly provide the following information in order to register:​​​​​​

Last Name
Last Name is required. Last Name must be letters only.
First and Middle Name(s)
First and Middle Name is required. First and Middle Name must be letters only.
Last Name at enrolment (if different)
Name is required. Name at the time of enrolment must be letters only.
Date of birth (Optional)
Date of birth is required.
Gender
Programme(s) completed at AKU (Check all that apply)
  • {{album.name}}

{{msg}}
Year of completion:
Year of completion:
Year of completion:
Year of completion:
Year of completion:
chckbox is required.
Additional Programme Completed at AKU (if applicable)
Year of Completion
City is required. Year must be numbers only.
Additional certification(s)/ degree(s) completed at other institutions: (if multiple, separate by commas)
Name of corresponding institution(s)/certifying authorities (if multiple, separate by commas)
City is required. must be alphabets
Email
Email id is required. Email id not valid.
Confirm email
Confirm email id is required. Confirm email id not valid. Confirm email must match. Confirm email must match
Alternate email
Email id is required. Alternate email id not valid.
Employment organisation
Current employment is required. Employment organisation must be letters only.
Job title
Current designation/speciality is required. Job title must be letters only.
Speciality (if any)
Current designation/speciality is required. Job title must be letters only.
Home Address
Current designation/speciality is required. Job title must be letters only.
City
City is required. City name must be letters only.
Province/State
Province is required. Province name must be letters only.
Postal Code/Zip Code
Country
Please Select Country.
Mobile/Cell number
Mobile must be numbers only.