SALT Club - Premium Experience

Member Registration

Fill out the form below to become a member of SALT Club

Full Name (in Bangla) *

Full Name (in English) *

Father’s Name *

Mother’s Name *

Spouse/Husband Name

Date of Birth *

Blood Group *

National ID Number

Height

Weight

Children

Profile Picture Passport size photo (Max 2MB)

Mobile Number *

Whatsapp Number

Email Address

Present Address *

Permanent Address *

SSC Passing Year *

School Name *

Current Occupation

Organization Name

Hobby

Comments

Select Membership Type *

Bkash: 01XXX-XXXXXX (Personal)

Nagad: 01XXX-XXXXXX

Bank: Account No - XXXXXXXXXXXX (Bank Name)

Payment Method *

Transaction ID / Reference Number

Emergency Contact Name

Relation

Emergency Contact Number

I have read and agree to the constitution and rules of SALT Club.

I confirm that all information provided is true and correct.

I pledge to follow the code of conduct and uphold the reputation of the club.