Membership Application

Association Membership Application Form

Complete every applicable field from the membership form. The application and attachments will be submitted to BIAM for review.

Application progress

0 of 25 primary required fields completed.

Applicant Identity

Personal identity details from the membership application.

Applicant name in Bangla *

Applicant name in English *

Father's name in Bangla *

Father's name in English *

Mother's name in Bangla *

Mother's name in English *

Date of birth *

Gender *

Religion *

Blood group *

Marital status

National ID *

TIN

Service and Office Details

BCS service, cadre, batch, and office posting information.

Service ID *

Batch *

Joining Date *

Cadre

Current designation *

Office name *

Office address

Contact Details

Permanent, present, and direct contact information.

Permanent address *

Present address *

Mobile number *

Alternate phone

Email *

Emergency Contact

Emergency contact information.

Contact person name *

Relationship *

Mobile number *

Alternate phone

Address *

Payment Information

Payment method, bank reference, payment date, and receipt details.

Total payable amount *

Payment method *

Bank name

Branch name

Account number

Transaction / cheque / pay order reference

Payment date *

Payment receipt *

Nominee Details

Add one or more nominees. Include guardian details when the nominee is a minor.

Allocated: 0% · Remaining: 100%

Nominee 1

Project name *

Number of shares *

Nominee name in Bangla *

Nominee name in English *

Father/spouse name in Bangla *

Father/spouse name in English *

Mother's name in Bangla *

Mother's name in English *

Occupation

Relationship with applicant *

Date of birth *

Gender *

Religion *

Marital status *

Nationality *

National ID *

Birth certificate number

E-TIN number

Mobile number *

Allocation percentage *

Permanent address *

Present address *

Successor details if nominee is not adult

Skip this part if the nominee is an adult. Fill it only when the nominee is a minor or needs a successor/guardian record.

Successor name if nominee dies

Successor father/spouse name

Successor mother's name

Successor date of birth

Successor national ID

Successor relation

Successor permanent address

Guardian name

Guardian relation

Guardian mobile

Guardian address

Nominee photo *

Maximum dimensions: 531 × 650 px; maximum file size: 2 MB.

Nominee signature / thumb impression *

Maximum dimensions: 300 × 80 px; maximum file size: 2 MB.

Nominee NID / birth certificate copy *

Project Interest

Select the project where you are interested in buying shares. This selection is saved with your application but is not printed in the PDF.

Interested project *

Attachments

Required applicant identity, payment, and signature documents from the form. Service or office ID proof is optional.

Applicant passport-size photo *

Maximum dimensions: 531 × 650 px; maximum file size: 2 MB.

Applicant signature *

Maximum dimensions: 300 × 80 px; maximum file size: 2 MB.

National ID copy *

TIN certificate copy *

Service / office ID proof

I declare that the information provided in this application is true and complete. I agree to follow the rules, regulations, and decisions of the society. *