Reg. No-S-13500/2021

News Broadcaster's Allience Society Of Bangladesh

Membership Application

Presenter Name (as NID)

Screen Name

Profile Picture

Father's Name

Mother's Name

Date of Birth

Gender

Male

Female

Others

Marital Status

Single

Married

Divorced

Widowed

NID/Passport Number

Mobile No

WhatsApp No

Email Address

Present Address

Permanent Address

Blood Group

A+

A-

B+

B-

O+

O-

AB+

AB-

First Channel (On Air)

First Channel On Air Date

Present Channel

Membership Payment

Payment for General (500 BDT)

Payment for Lifetime (5000 BDT)

Membership Category

New Entry

Renewal

Lifetime

Previous Membership Category

General

Lifetime

N/A

bKash TrxID

Camp Office: Lift-5, House-82/1, Road-2, Block-A, Niketon, Gulshan, Dhaka

Cell No.: 01913262212; 01309712444

Website: www.nbabd.org