Registration Form
Charity activities are taken place around the world.
Full Name:
(Required)
পূর্ণ নাম (In Bangla)
Date Of Birth:
DD slash MM slash YYYY
Father's Name:
Mother's Name
Mobile Number:
(Required)
Email Address:
Emergency Contact No.:
Current Address:
(Required)
Permanent Address:
Institute or Business Name:
Profession & Designation:
Shift:
(Required)
Morning
Day
Section:
(Required)
A
B
S.S.C Registration Number:
Payment Amount(BDT):
(Required)
Payment by:
(Required)
Bank Account
Bkash
Nagad
Cash
Payment To:
(Required)
Babul: Bkash and Nagad-01716353443
Rafiq: Bkash and Nagad-01791747651
Bank Account: Name: PZS-97 No: 3962010011644, Rupali Bank PLC. Br-Gopalpur, Pabna. Routing no.-185761093
Other
T-Shirt Size:
(Required)
S: Chest-36" Length-26"
M: Chest-38" Length-27"
L: Chest-40" Length-28"
XL: Chest-42" Length-29"
XXL: Chest-44" Length-30"
Other
Blood Group
A (+)
A (-)
B (+)
B (-)
AB (+)
AB (-)
O (+)
O (-)
Photo (Passport Size)
Accepted file types: jpg, png, Max. file size: 2 MB.
Categories
4
Raise Fund for Clean Water and Healthy Food
Achive:
$8,000.00
Goal:
$18,000.00
Raised
44.4%
4
Give African Childrens a good Education & Healthy
Achive:
$8,000.00
Goal:
$18,000.00
Raised
44.4%
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