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Application Form

CARD APPLICANT DETAILS

Name*  
CPR*    
Mobile*  
Telephone  
Email  

Address

Type:

 
Flat/Building*  
Road*  
Block*  
Area/City*  

REQUEST TYPE

 

*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)*
   

Name to appear on the card

Line 1
Line 2

FEATURES REQUIRED

 
1. Restrict Card to one vehicle?*

If yes, vehicle no*    
 
2. Restrict usage of card to fuel type?*



Remarks *Restriction feature ensures all fuel transaction is limited to the listed vehicle

Delivery



 
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.