Create Account

Principal Applicant: First Name Last Name Cell Phone Home Phone Your Email Street # and Name Apartment # City State / Province ZIP/Postal Code

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Spouse: First Name Last Name

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Unmarried Children: First Name Last Name Add More Child

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EMERGENCY CONTACT: Full Name Phone Number

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Please download and complete following form:
Pre Authorization Form

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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