All Lawfull Rangpur born residents in the United States are invited for membership. Please fill out the form and mail it to the office of the Association at 9760 108th St, South Richmond Hill, NY 11419, USA.

Rangpur Zilla Association, Inc

                                       New York, USA



Membership Form:


 Name: __________________________________________


Permanent Address in Bangladesh:


Village:                                                    P.O.                                         

P.S.                                                          District:                                     


Telephone Number:  



Address in USA:


Street Number and Name:


Apartment Number:


City:                                                                   State and Zip Code:            


Home Telephone:                                              Cell Phone:                                     


I certify that the information given in this form is correct to the best of my knowledge.



 Date:                                                                       Applicant's Signature



      Verified By: President/Secretary/Membership Committee

 Rangpur Zilla Association, Inc