Request edit access
Membership Application 
A separate membership application is required for each individual.
Sign in to Google to save your progress. Learn more
Email *
Member Information
Name (Last, First, Middle) *
Age (>18 yrs) *
Street Address *
City & State *
Zip Code *
County *
Length of stay at this address (Years & Months) *
Phone (Cell) *
Phone (Home)
Phone (Work)
E-mail *
Legal Resident of USA? *
Would you like to Volunteer in any commitee of the ISWMD? *
If yes, please indicate your interest list previous experience, if any: (If not, leave blank)
Spouse Information
Optional (For Directory Listing)
Name (Last, First, Middle)
Phone (Cell)
Phone (Work)
Children Information 
Optional (For Directory Listing)
Name(s) (Last, First, Middle)
Age(s) (yrs)
Annual membership dues are $50 per member ($25 for full-time students) - from January 1 to December 31. If you have paid $50 or more to ISWMD in any category (other than Zakat) during the previous year, your membership dues are considered paid. If you paid $100 or more, your spouse dues are also considered paid. 

Do you want you dues waived for financial hardship?
Would you like to be added to the ISWMD Bulletin Board? (WhatsApp Group) *
If so, please list the number(s) that you would like added. (If not, leave blank)
Date completed *
Membership Dues can be paid via Credit Card or PayPal on the Masjid website or by Check (Placed in drop box in the Masjid, with membership written in the memo)
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy