General Body Membership Form Personal Information First Name: Last Name: Middle Initial: Gender: MaleFemale Marital Status: SingleMarried Spouse’s Name: Contact Information Home Phone: Mobile Phone: Email Address 1: Email Address 2: Address Street Address: City: State: Zip: Profession Work: Profession: Family Members Information 1. Name: Age: Gender: –SELECT ONE–MaleFemale 2. Name: Age: Gender: –SELECT ONE–MaleFemale 3. Name: Age: Gender: –SELECT ONE–MaleFemale 4. Name: Age: Gender: –SELECT ONE–MaleFemale I so testify that I’m an adult Muslim, legal resident of the USA and I follow the teaching of the Qur’an and the Sunnah of Prophet Mohammad Peace and Blessings be up on him and I believe and testify that he is the last and seal of all prophecy. I promise to comply with the rules of the association as it is set forth. Signed: This day of: By signing this membership you forfeit the right to any litigation against MIA and/or its management. Any such issues may ONLY be resolved by the Islamic Arbitration.