Mastercard ~~ E 3 & NOVOAIR Su FReSuenTPvER astern Bank te Sim Mos NOVOAIR - EBL Co-Branded Card Application Form ry ea Area Phot Please fill in the form in CAPITAL LETTERS and attach all the documents specified in this form, Please complete all sections. Tick boxes wherever necessary. First Name" (Mr/Ms/Dr.) Last Name" printed on Card* (Maximum 19 char ding spaces) Sex Postal/Mailling Address Male (J Female Nationality NOVOAIR SMILES Number NID or Passport Number Mother's Maiden Name Mobile™ Nominee Name Email ID Nominee Date of Birth Relationship with Applicant “These Information may be used to veriy your identity when you want your card account details ove Declaration hereby agree to recieve marketing materials, communications and information, promotional offers, newsletters and any other communication on products and services of NOVOAIR and EBL. | have read and agree: and EBL Terms, Conditions and Privacy Policy. Ihave attached the following documents: (anyone) A self-attested copy of [National ID Card [] Passport [Office ID/LO! [] Other to the NOVOAIR Frequent Flyer rules ‘Applicant's Signatu Signature verified by NOVOAIR Co-Branded Card No: Issue Date: EBL Authorized Signature: ‘SMILES EBL Cards Center NOVOAIR Limit a Tower (3rd Floor House 50 Road "Black F -52, Gulshan North C/A Benoni Draka 1215 Bangladesh Dhaka 212 Bang ades helpline: 13 24 Hours N 88.02 8232232 +88 0285042135 isbsite: wirw.llyn ‘ax, BE 02 9882316 aircom/SMILES Website: wwnceblicombe