ICON College

Alumni Registration Form

(* means mandatory field need to be filled.)

1. Title*

2. First Name*

3. Surname*

4. Gender

Male
Female
Other

5. Nationality

6. Address

7. Contact No

8. E-mail*

9. Student ID

10. Course Detail*

11. Course Start Year

12. Course Completion Year

13. Current Status

Other (Please Specify):

14. Name of Employer/Organisation/
College/University
(if Applicable)

15. If you would like to receive information from ICON College, please tick the relevant box*

Telephone/Mobile
By E-mail
By Post
No thanks, I don't want to be contacted