Programme:		Official date of birth:
Year of graduating:
Your name (as in XIMB records):
Personal Email address:
Alternative Email address:
Designation (or suitable description):
Organisation:
Contact address (Line 1):
Contact address (Line 2):
Contact Telephone (Home):
Contact Telephone (Work):
Contact Telephone (Mobile):
Fax Number:

    The data will be sent only to the XIMB Alumni Office.