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Membership Application
A separate membership application is required for each individual.
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* Indicates required question
Email
*
Your email
Member
Information
Name (Last, First, Middle)
*
Your answer
Age (>18 yrs)
*
Yes
No
Profession/Business
Your answer
Street Address
*
Your answer
City & State
*
Your answer
Zip Code
*
Your answer
County
*
Your answer
Length of stay at this address (Years & Months)
*
Your answer
Phone (Cell)
*
Your answer
Phone (Home)
Your answer
Phone (Work)
Your answer
E-mail
*
Your answer
Legal Resident of USA?
*
Yes
No
Would you like to Volunteer in any commitee of the ISWMD?
*
Yes
No
If yes, please indicate your interest list previous experience, if any: (If not, leave blank)
Your answer
Spouse
Information
Optional (For Directory Listing)
Name (Last, First, Middle)
Your answer
Profession/Business
Your answer
Phone (Cell)
Your answer
Phone (Work)
Your answer
E-mail
Your answer
Children
Information
Optional (For Directory Listing)
Name(s) (Last, First, Middle)
Your answer
Age(s) (yrs)
Your answer
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?
*
Yes
No
Would you like to be added to the ISWMD Bulletin Board? (WhatsApp Group)
*
Yes
No
If so, please list the number(s) that you would like added. (If not, leave blank)
Your answer
Date completed
*
MM
/
DD
/
YYYY
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)
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