Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.MEMBER PERSONAL INFORMATION – Step 1 of 4First Name: *Family Name:Father Name:Mother Name:Mobile: *Home Phone:Fax:Company Name:Place of Residence:Work/Job Name:Place of Birth:Email *Company Address:Birth date:P.O.B:NextService Domain:Service Type:Service Unit Points Value:Service Max Allowed Points:Service Address:How long at current address?Bank name:Bank address:Work Phone:Name *Phone Number: *NextMembers who open their services account with us must be able to provide services to our other members. One must pay a certain registration fee to create an account. Applying students must be registered at university and have their university ID card with them to open an account. I authorize the verification of the information provided on this form as to my credit and services. I have received a copy of this application. By signing this form, I hereby declare that I understand and accept the conditions of participation and payment, and I acknowledge the services I provide in return for points received by Services Bank members.NextAgent name *Agent Date Name of member: *Member Signatures DateSupervisor: *Supervisor DatePassword *PasswordConfirm Password www.services-bank.comSubmit