Barind Multipurpose Development Authority (BMDA)
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Pre-Paid Card Application Form
Applicant Information
Circle
*
-- Select Circle --
Region
*
-- Select Region --
Zone
*
-- Select Zone --
Name
*
Father's Name
*
Mother's Name
*
National ID Number (NID)
*
Date of Birth
Age
Educational Qualification
Mobile Number
*
Photo
JPG/PNG, max 2 MB
Address
Village
Union
Post Office
Upazila/Thana
District
Well Details
Union
Mouza
JL No
Dag No
Vending Station
District
Land Area (Bigha / 33 Decimal)
Own
Borga
Lease
Total
Remarks
I declare that all the information provided above is true and correct.
*
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