Membership application

Complete the fields reflected in the club membership form. Identity numbers are encrypted at rest.

1. Personal information

Full name *

Full name in Bangla

Father's name *

Mother's name *

Spouse name

Nominee's name *

Date of birth *

Nationality *

Membership category *

Identity document type *

Identity document number *

Only the last four characters are shown after submission.

2. Contact and professional information

Email *

Mobile *

Present address *

Permanent address *

Profession / occupation *

Company / organization

Designation

3. Social and professional profiles (optional)

Facebook

Instagram

4. Proposer and seconder recommendation

Provide these details when known. The administration will verify member numbers.

Proposer name (founder member)

Proposer membership ID

Seconder name (existing member)

Seconder membership ID

5. Declaration and submission

I agree to abide by the constitution, rules, regulations, code of conduct, and decisions of the Club Authority, and declare that the supplied information is accurate. *

This online consent records the applicant signature timestamp. Fees and final approval are completed after office verification.