BANGLADESH NATIONAL PHILATELIC ASSOCIATION

 G.P.O. BOX NO-790,DHAKA-1000,BANGLADESH

Name                        :

Profession                 :Sex: Malefemale

Postal address            :

Telephone                 :(Res)(Off)

E-mail                       :

Fax                           :Marital Status  :

Hobbies                    :

recommended by       :

Date                         :

...............................

Signature of the applicant

Yearly Membership Fee:

Tk.100.00 for Bangladeshi Resident & $15 for foreign Resident.

Life Membership Fee:

Tk.2000.00 for Bangladeshy Resident & $100 for Foreign Resident.

FOR OFFICIAL USE ONLY

Receipt No:.......................Date:...................Taka...............

Membership No;..........................................................................

 .........................................

Signature of the Finance Secretary

*Post this form by filling up properly to G.P.O. BOX NO-790 with postal order/money order of Membership Fees.

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