TOBUO a mid-monthly household supplement

SUBSCRIPTION FORM

[please use block letters]

NAME: ..........................................................................................................

RESIDENCE ADDRESS: ...................................................................................

....................................................................................................................

...................................................................... POSTCODE: ............................

PHONE: .......................................... EMAIL: ...................................................

DATE OF BIRTH: ..................................... OCCUPATION: ..................................

DESIGNATION: .................................... COMPANY:..........................................

[please tick] SEX: MALE...... FEMALE.......

THANK YOU FOR MAKING ME A REGULAR TOBUO SUBSCRIBER!

SIGN: ..................................................... DATE: ...........................................

[please send the form to the address below:]

TOBUO, Apt#4C, House#B-173, Road#23, NEW DOHS, MOHAKHALI, DHAKA-1206, BANGLADESH

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