General Body Membership Form

masjid

Personal Information

First Name:

Last Name:

Middle Initial:

Gender:

Marital Status:

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:

2. Name:

Age:

Gender:

3. Name:

Age:

Gender:

4. Name:

Age:

Gender:

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.