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BIC Membership Application
Fill up this form to join the BIC membership 
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Email *
Full Name  *
Phone  *
Address  *
Membership Class (Annual Fee)  *
Spouse Name 
Children Name  and Year of Birth 
Children Name  and Year of Birth 
Children Name  and Year of Birth 
Children Name  and Year of Birth 
Applicant's Statement: I bear witness that there is no deity to be worshipped except Allah SWT, and Muhammad (PBUH) is His last and final messenger. If admitted to membership, I shall agree to abide the Bylaws of BIC and the decisions of BIC Board. I shall be considered as a Member of BIC from the date this application, once approved and signed by BIC board. (BIC Bylaws are available at www.bicjax.org) *
Signature  *
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