Membership Application Form

Yes, I am between the ages of 21 and 39 and want to become a member. Passport Size

OFFICE USE ONLY

Name of the LOM:
Application # Photo
Application Date:

Name:
Sex:
Male
Female Date of birth: dd / mm / yyyy Blood Group:
Company Name:
Job Title:
Work Address:
Phone: Fax:
Email:
URL:
Business Classification: (Please check the box according to your business type)

Accounting / Auditing
Advertising / Promotion
Construction / Engineering / Building
Supply / Renovation

Cafe / Restaurant / Hotel
Entertainment
Education / Educational Supply
Finance / Banking / Exchange

Manufacturer
Government / Civil Servant
Information Technology
Medical / Laboratory
Trading

Service / Insurance
Legal
Travel / Transportation
Other (please specify) ________________________

Education Qualification:
Home Address:
Phone: Fax:
Mobile:
Marital Status:
Single
Married Wedding Anniversary:

Introduced by Applicant

Name, Signature & Date Signature & Date

Personal Interest Information: (Please check the box according to your interest)
Individual Area of Opportunity

Personal Development
Meetings

Trainer
Training

Membership Growth & Extension

Community Area of Opportunity

JCI Major Emphasis Theme
Community Development

Economic Affairs
Children & Youth

Governmental & Civil Affairs

International Area of Opportunity

International Affairs & Relations
Chapter Twinning

JCI Meeting
Awards

Business Area of Opportunity

Finance
Records

Strategic Planning
Marketing & Public Relations

Business Affairs
Chamber of Commerce Partnership

OFFICE USE ONLY

Membership Approval By LOM Membership Approval By NOM

Signature & Date Signature & Date

Membership ID #

MEMBERSHIP PROCEDURE
• Fill-up the Membership Application Form with one copy passport size photo
• Submit your Membership Application Form to any of the Chapter’s Secretary General
• Attend at least one Monthly General Meetings (MGM)
• After getting the approval from the Chapter Membership Development Committee your Membership Application
Form will be forwarded to National Membership Development Committee for further approval
• Again after approve from National Membership Development Committee and National Governing Body (NGB),
you will be awarded the JCI Membership at the following Chapter’s Monthly General Meeting (MGM) after paying
the JCI Bangladesh dues
• JOIN JCI Bangladesh, be a Jaycees