Registration Form

13 & 14 November 2026 (Friday & Saturday) | C.S.S. Ava Center, 82 Rupsha Strand Road, Khulna.

Head Office: 33, 33/1 Greenmart Market (2nd Floor), Dhanmondi, Dhaka-1205.

Corporate Office: 31 Ahsan Ahmed Road, P.T.I More, Khulna-9100.

13 & 14 November 2026 (Friday & Saturday) | C.S.S. Ava Center, 82 Rupsha Strand Road, Khulna.

[ Registration Form ]

অনুগ্রহ করে সকল তথ্য সঠিকভাবে পূরণ করুন। আপনার দেওয়া সকল তথ্য গোপন রাখা হবে।

Passport Size Photo
(ছবি যুক্ত করুন)

Applicant Name (Bengali)

Applicant Name (English Capital Letters) *

Father's Name

Mother's Name

Permanent Address

Present Address

Nationality

Date of Birth

Religion

National ID (NID) No.

Mobile No. *

WhatsApp No.

Email Address

Blood Group

Educational Qualification

Registration Fee Deposit Receipt No. *

Astrology Educational Qualification (if any)

Title/Award Received in Astrology (if any)

👉 Do you wish to deliver a speech at the conference? (Must be astrology-related)

Palmistry / Vedic Astrology / Numerology / Mundane / Vastu / Krishnamurti method (no repetition)

Yes

👉 Will you be responsible in making the conference a grand success?

Yes

👉 Are you willing to perform tasks assigned by authority?

Yes

👉 Do you require hotel / accommodation? (Charges apply)

Yes

Applicant's Signature (Name / Digital Signature) *

Signature Image (Optional File Upload)

Date

General Secretary

Bangladesh Radiance Astrologers Society

Applicant's Signature