Branch : City Stars Digital Branch

Date - Time : 28-11-2023 10:43:00 AM

National ID Number (14 Digits)*  

Full Name as per National ID*  

Address as per National ID*  

Birth Date*    

Birth Country*  

Issue Date*    

Expiry Date*    

Gender* Select Gender... Male Female  

Nationality*  

Marital Status Marital Status... Single Married Divorced Widowed  

Educational Degree* Select Qualification... Master/PhD Bachelor Diploma Other  

Mailing Address*  

Mobile*  

Email*    

Home Telephone Number

Job

Employer Name

Employer Address

Work Phone

Monthly Salary(EGP) Select Monthly Salary... Above 30000 10000 to 30000 Less Than 10000

Source of Income

Other Sources of Income

Nearest Branch* Cairo Port Said Ismailia Sporting-Alexandria Giza Maadi Suez Tanta Heliopolis Dokki Islamic Branch Mohandeseen Bani Swafe Roshdy Arkan Operation Center Hurgada 10th of Ramadan Obour Sphinx Orouba El Fostat Nasr City El Sadat Sharm El Sheikh Garden City Borg Al Arab Smouha Smash Club Airport Branch 6th of October University Amreya 6th of October City Damietta New Port Branch Mansourah El Menia Assiut Teda Ain El Sokhna Shoubra El Manial El-Tagamoa El-Khames Port Tawfik Economic Zone - Ain Sokhna El-Ahrar - Mohandeseen TOP 90 NEW CAIRO MADINATY Ismalia Sheikh Zayed Makram Ebeid Al-Hosary Magles El Dawla Gleem Qena City Stars

Mobile Number for Service*  

Operator* Select Operator... Vodafone Etisalat Orange WE  

Existing Bank Account?* Select Existing Bank Account... Yes No  

Bank Customer Account(16 Digits)

Are you the real beneficiary?* Select if you real beneficiary... Yes No  

Beneficiary Name

Beneficiary Nationality

Validation Code *