Membership Registration Form

Your Name(*)

Please type your full name.

Telephone(*)

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Email address(*)

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Your Address

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Subject

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Name of attached hall

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Batch Number

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Membership Fees:

Please pay £20.00

Payment Information: BACS Payment /Cheque/ Bank Payment
Bank: Lloyds Bank
Name: Chittagong University Ex Students Association UK (CUESA UK)
Sort Code: 30-99-50
Account no: 46419463
Please put the reference as YOUR FULL NAME as per the registration form and ensure that the appropriate fee is paid to guarantee your registration.

Please upload a most recent passport size Photo

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DECLARATION:
I, the undersigned solemnly declare that I understood the aims and objectives of Chittagong University Ex-Students Association UK and agree to abide by the rules. I authorise the Executive Committee/ Election Commission to receive and send information to and from third parties relating to matters associated with my membership, including management of events, contacts lists, invitations, and other matters associated with CUESA UK.

Yes, I Agree(*)

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