Membership Application Form

Name

Other Names

Address

Parish

Mailing Address (if different from above)

Gender

Male

Female

Citizenship

Country of Birth

Date of Birth

Phone

Please Provide Two (2) Forms of ID:

1st Form of Identification

National ID No.

Passport No.

Drivers License No.

2nd Form of Identification

National ID No.

Passport No.

Drivers License No.

NIS No.

TAMIS No.

If you are human, leave this field blank.

“The John W. Lovell Building” Lower Collymore Rock St. Michael, Barbados, W.I.

Opening Hours: Mon – Fri 9:00am – 5:00pm

Tel. (246) 426-3657

Email. info@barteachcredit.com

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