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Application Form
CARD APPLICANT DETAILS
First Name
*
Middle/Second Name
Last Name
*
CPR
*
Mobile
*
Telephone
Email
Address
Type
:
Flat and Building
House/Villa
Flat/Building
*
Road
*
Block
*
Area/City
*
REQUEST TYPE
New Card
Renew or Lost Existing Card
*
Valid CPR – front and backside
Please, write or specify the existing card number
*
Upload CPR(only JPG,JPEG,PNG and PDF format of file allowed,2MB)
*
FEATURES REQUIRED
1. Restrict Card to one vehicle?
*
No
Yes
Record vehicle no
If yes, vehicle no
*
2. Restrict usage of card to fuel type?
*
Open to all
Jayyid
Diesel
Mumtaz
Super
Remarks
*
Restriction feature ensures all fuel transaction is limited to the listed vehicle
Delivery
Mailing Address ( It takes about 10 working days to be delivered)
Select Nearest Location
Muharraq Club Fuel Station (Arad)
Hidd Consumer (Al Hidd)
Qalali Fuel Station (Qalali)
Al Hoora Fuel Station (Al Hoora)
Central Market (Nearby Marina Mall)
Estiqlal (Sanad -Al Hekma School)
Isa Town Consumer (Isa Town)
Tubli Fuel Station (Nearby Al-Anwar Center)
Al Nuzha Fuel Station (Dar kulaib)
Al Rawadha Fuel Station ( Hamad Town Roundabout 7)
Saar Fuel Station (Neerby Alosra Supermarket)
Wadi Al Sail Fuel Station (Nearby BDF Hospital)
Al Shurooq Fuel Station (Nuwaidrat)
Other person on my behalf
Authorized person's CPR
*
I confirm that I have read and understand the
Terms and Conditions
and I agree to be bound by them. I also confirm that all the information supplied to the Bahrain Petroleum Company in this form is, to the best of my knowledge, true and correct.