Management FBS Club Ltd.

Rupayan Karim Tower, 80 Kakrail VIP Road (11th floor), Dhaka-1000, Bangladesh.

Email:info@managementfbsclub, web:www.managementfbsclub.com

Application Form For Membership

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NAME OF THE APPLICANT*:

NAME OF DEGREE*:	B.COM(Hon's)	M.COM	BBA	MBA
	PHD	DBA	OTHERS

NAME OF UNIVERSITY*:

SESSION/BATCH*:

MEMBERSHIP TYPE*:	GENERAL	PERMANENT	LIFE	HONORARY
	CORPORATE	TEMPORARY	ASSOCIATE	DONER

PERSONAL INFORMATION

GENDER*:

MALE

FEMALE

BLOOD GROUP*:

DATE OF BIRTH*:

MARITAL*:

MARRIED

UNMARRIED

RELIGION*:

ISLAM

HINDU

CHRISTIAN

OTHER

NATIONALITY*:

NID NO*:

PASSPORT NO:

TIN NUMBER:

PRESENT ADDRESS*:

PERMANENT ADDRESS*:

PROFESSIONAL INFORMATION:

ORGANIZATION*:

DESIGNATION*:

ADDRESS*:

CONTACT NO*:

ALTERNATIVE CONTACT NO*:

E-MAIL*:

FAMILY MEMBERS INFORMATION:

RELATION

NAME

GENDER

DATE OF BIRTH

OCCUPATION

NOMINEE:

NAME*:

RELATIONSHIP*:

DATE OF BIRTH*:

PASSPORT NO:

NID NO:

If nominee has no NID/PASSPORT then provide birth certificate number:

Area of Interest:

Cricket	Table Tennis	Pool	Tennis	Caram
Football	Card Games	Housie	Chess	Salon
Basket Ball	Beauty Parlor	Health Center	Swimming	Bakery
Badminton	Dining	Library	Music	Travelling
Other

I hereby declare that the information provided above is true to the best of my knowledge. I understand that any false declaration will make my application liable to cancellation & may result in expulsion from the Club even if I am selected as a member. I also agree to abide by all the rules, regulations and code of conducts of MFBSCL.