Create Account Principal Applicant: First Name Last Name Cell Phone Home Phone Your Email Street # and Name Apartment # City State / Province ZIP/Postal Code Spouse: First Name Last Name Unmarried Children: First Name Last Name Add More Child EMERGENCY CONTACT: Full Name Phone Number Please download and complete following form: Pre Authorization Form Tick this box if you confirm all above information is correct and you agree to be a member of Bangladesh Muslim Funeral Services (BMFS) by obeying BMFS's policy and ready to pay registration fee as shown below. > Please email us a copy of the completed Pre Authorization form and void cheque at info@bmfs.ca right after the payment. These two documents are mandatory for BMFS membership and we can only activate your account after we receive them. > Please note that Your membership will be effective thirty (30) days from the day of registration. Cancellation of your membership at any time is non refundable. Total Payment: Card Number Expiration (MM) Expiration (YYYY) CVC