Name of Your oganization
:
Name of the applicant
:
Put here the name of the Owner, Chairman, Managing Director,CEO etc. as applicant (Whatever is applicable)
Designation of the applicant
:
Address of the
:
Address 1
Address 2
District
---Select District---
Bagerhat
Bandarban
Barguna
Barisal
Bhola
Bogra
Brahmanbaria
Chandpur
Chapai Nawabganj
Chittagong
Chuadanga
Comilla
Cox's Bazar
Dhaka
Dinajpur
Faridpur
Feni
Gaibandha
Gazipur
Gopalganj
Habiganj
Jamalpur
Jessore
Jhalokathi
Jhenaidah
Joypurhat
Khagrachari
Khulna
Kishoreganj
Kurigram
Kushtia
Laksmipur
Lalmonirhat
Madaripur
Magura
Manikganj
Meherpur
Moulvibazar
Munshiganj
Mymensingh
Naogaon
Narail
Narayanganj
Natore
Netrokona
Nilphamari
Noakhali
Norshingdi
Pabna
Panchagarh
Patuakhali
Perojpur
Rajbari
Rajshahi
Rangamati
Rangpur
Satkhira
Shariatpur
Sherpur
Sirajganj
Sunamganj
Sylhet
Tangail
Thakurgaon
Organization Type
:
---Select organization type---
Industry
Super Market
Super Store
Real Estate
University
Hotel
Appartment
Hospital
Police Department
Other
If organization type is other, please specify it below.
Business type of the
:
--Select business type--
Manufacture
Export-Import
Tourism
Developer
Land Seller
Retailer
Health Care
Education
Law Enforcement
Other
If your business type is other, please specify it below.
Probable threats
:
Please mention probable threats you feel for which you want to deploy embodied Asnars.
Area of responsibilities
:
Please specify clearly at what areas you want security from deployed Asnars. Specific security responsibilities will help the Ansar Personnel to discharge their duties effectively.
Number of Ansars
:
Arm Guard
:
--Select Yes or No--
No
Yes
If you expect Armed Ansar Guard, please mention 'Yes'.
Strong room for Arms
:
--Select Yes or No--
No
Yes
If you expect Armed Ansar Guard, there must have strog room for Arms
Barrack
:
--Select Yes or No--
No
Yes
Is there any furnished barrack for deployable Asnars ?
Barrack Type
:
--select one--
Building
Semi Pucca
Tin Shed
Other
Please mention accomodation type for the deployabel Asnars.
Toilet
:
No
Yes
--Select Yes or No--
Is toitel facilities for the deployable Ansars sufficient ?
Kitchen
:
No
Yes
--Select Yes or No--
Are the cooking and dining facilities availa for the Ansars ?
Gas
:
--Select Yes or No--
No
Yes
Is there gas suppply for Ansar's cooking ?
Electricity
:
--Select Yes or No--
No
Yes
Is there power supply at proposed barrack and security points ?
Any legal
:
No
Yes
--Select Yes or No--
Is there any legal obligation regarding the properties where Ansars will be deployed.
Declaration of legal issues
:
If Yes , please specify here.
Mode of payment
:
Yearly
Half Yearly
Quarterly
What would be the mode of payment of deployed Ansars' remuneration ?
Contact person
:
for deployment process of Ansars
Designation
:
Phone
:
Area code-number )
Cell Number
:
Fax
:
Email
:
Date of submission
:
yyyy-mm-dd ) Date of submitting application
