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Al Barakah: Multi-Purpose Co-Operative Society Limited (Regd. No. 1269) Tel: 6275766

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Tijjani Ridwanulah Adewale

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Al Barakah: Multi-Purpose Co-Operative Society Limited (Regd. No. 1269) Tel: 6275766

Uploaded by

Tijjani Ridwanulah Adewale
18 views1 page
___________________________

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18 views1 page

Al Barakah: Multi-Purpose Co-Operative Society Limited (Regd. No. 1269) Tel: 6275766

Uploaded by

Tijjani Ridwanulah Adewale
___________________________

Copyright:

Attribution Non-Commercial (BY-NC)
Download as PDF, TXT or read online from Scribd
Download as pdf or txt
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In the name of Allah, the Beneficent, the Merciful

OFFICE USE
Region:______

AL BARAKAH
Multi-purpose Co-operative Society Limited (Regd. No. 1269)
Tel: 6275766

SRN:AB______

Co-operate in what is good and pious and do not co-operate in what is sinful and wicked(Q-5:2)

MEMBERSHIP APPLICATION FORM


Surname(Mr./Mrs./Miss):___________________________________________ Maiden Name:___________________
First Name:__________________________________________ Date of Birth:_____/________/______ Age:______
Sex : Male

Female

Marital Status: Single

Married

Other____________________________________

Identity Card No.


Address:_________________________________________________________________________________________
Tel: (H)_______________

(Mb)_______________

E-Mail:______________________________________________

Name of Spouse:__________________________________________________________________________________
Occupation:__________________________________ Qualification:________________________________________
Name of Employer:________________________________________________________________________________
Address:___________________________________________________________ Tel:_________________________
In the event of death/insanity, I hereby nominate:
Surname(Mr./Mrs./Miss):_______________________________ First Name:__________________________________
Address:____________________________________________ Relation:____________________________________
Identity Card No.

to receive any money accruing to me in the society.

Declaration
I declare that the above information is true and correct to the best of my belief and that I shall abide by all the
Rules and Regulations of Al Barakah Multi-purpose Co-operative Society Limited if my application is approved.
Signature of Applicant:_____________________________________

Date: _____/________/_____

******************************************************************************************************************************************

Recommendation
Recommended by:__________________________________________

Shareholder No.

AB

Remarks:________________________________________________________________________________________
Signature:________________________________________________

Date: _____/________/_____

******************************************************************************************************************************************

OFFICE USE
Copies of documents required:

Applicants Identity Card


Nominees Identity Card

Birth Certificate
Birth Certificate

Utility Bill

Entry Fee: Rs______ + Shares: Rs________ Total: Rs___________ Receipt No.____________ Date:____________
Processed & Checked by Regional Representative: ________________________ Signature:___________________
BOARD

Approved

Not approved

Pending

Meeting held on:_____/________/_____

Remarks:_________________________________________________________________________________________
Chairperson:________________________________

SEAL

Secretary:_______________________________

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