Transperancy Intl > Membership Form Of Tib

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TRANSPARENCY INTERNATIONAL BANGLADESH MEMBERSHIP APPLICATION FORM

Dear Applicant, Thanks for your interest in Transparency International Bangladesh. Please fill up the following questions and kindly send it to our office at Progress Tower (5th Floor), House 1, Road 23, Gulshan 1, Dhaka 1212, Bangladesh. indly note that you may have to sit for an interview before we accept your Membership Application.

1. Name:

2. Date of Birth:

3. Mailing Address:

4. Permanent Address (if different from 3):

5. Telephones:

E-mail (if any):

7. Academic Qualification (please mention subject of specialization, if any):

8. Institutional affiliation (if any, including the last one): a. Designation: b. Name & contact details of organization:

c. TIN (If any):

9. Membership Category: (a) Individual Patron

(b) Life

(c) Donor

(d)

(Individual Membership for Professionals Taka 200/= and for Students Taka 100/=, Life Membership Taka 5000/=, Donor Membership Taka 1000/=, Patron Membership Taka 10000)

10. In what area and what way would you like to take part in/contribute to the work of TIB?

11. How do you think TIB could involve you as a member in its activities?

12. Please mention names of two referees (students should show valid identity of their institutions and a recommendation form their institution/department head)

Signature/ Date

MEMBERS ARE FULLY COMMITTED TO OBSERVE AND UPHOLD TIB CODE OF CONDUCT