BAL Registration Form

Blogger Registration, ID & Merchandise Order Form

Enter your details, choose your blog category, upload your photo/logo, and select any ID card and merchandise items.
Personal Information
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Blog Information
Name of Blog
Blog / Website URL
Type of Blog
If Other, Please Specify
Brief Description of the Blog
Uploads
Mobile Money Number - 0770123341 - Anthony Fofana
Passport-Size Photo

Cancelof
Blog Logo

Cancelof
Upload Receipt

Cancelof
Customized Merchandise
Select Merchandise Items
Customized Jacket Quantity
Customized T-Shirt Quantity
Customized Cap Quantity
Merchandise Total
TOTAL AMOUNT DUE
Jacket/T-Shirt/Cap Details
Preferred Jacket Size
Preferred T-Shirt Size
Cap Requested
Applicant's Declaration
Declaration Statement
Electronic Signature
Signature File Upload

Cancelof
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Attestation / Declaration
I certify that the information provided is true and complete.
Should be Empty:

Blogger Registration, ID & Merchandise Order Form