Name
Email
Mobile
If you are Student, Name of the College
If you are Student, Stream
Your Immediate Career Plan after Graduation? 1. If Further education in which degree 2. If Job in which Industry 3. If Entrepreneurship in which business
Where do you see Yourself in next 10 Years? 1. If Employment your designation 2. If Entrepreneur your Profit Target
Are you a Member of Rotaract Club? Answer in Yes or No.
If yes write the name of the Rotaract Club and If no, just write no.

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