Allied Group Satkhira

Member Registration

Personal

Identity

Nominee

Banking

Account

Personal Information

Full Name (English) *

Full Name (বাংলা)

Father's Name *

Mother's Name *

Date of Birth *

Gender *

Blood Group

Phone Number *

Secondary Phone

Occupation

Designation

Organization/Company

Present Address *

Same as present address Permanent Address *

Emergency Contact Name *

Emergency Contact Phone *

Relation with Emergency Contact *

Identity Documents

NID Number *

Passport Size Photo *

Recent passport size photo (max 2MB)

Signature Photo

Signature on white paper (max 1MB)

NID Front Side *

NID Back Side *

Nominee Information

Nominee will receive benefits in case of any emergency.

Nominee Full Name *

Relation with Nominee *

Nominee Phone *

Nominee NID Number *

Nominee Address *

Nominee Photo *

Nominee NID Front *

Nominee NID Back *

Banking Information

Optional but recommended for withdrawals and refunds.

Bank Name

Branch Name

Account Holder Name

Account Number

Routing Number

Account Type

Mobile Banking (Optional)

Mobile Banking Provider

Mobile Banking Number

Account Setup

Email Address *

You'll receive approval notification on this email

Password *

Confirm Password *

I agree to the terms and conditions. I confirm that all information provided is accurate and documents are genuine.

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