Membership Application
Email address *
Name of applicant organization: *
Organization's address:
Organization's phone number:
Name of contact: *
Contact phone number: *
Membership category requested: *
Is the organization incorporated? *
If Yes to previous question, which state?
Year incorporated:
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Clear selection
Clear selection
Is the organization an Arizona chapter of a national organization? *
Has the applicant chapter been operating in Arizona in the current status for two or more years? *
Is the organization federal tax exempt by the IRS as 501-c? *
Date of IRS tax exempt letter
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DD
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Does the organization have a governing board of 5 members or more? *
Please list the names and position of the current board members: *
Does the organization have members and if so, how many? *
Does the organization have a corporate bylaw or an article of incorporation, which clearly sates its Islamic nature? *
Is the applicant an organization or business? *
Describe how the applicant's operation benefits the Muslim community: *
I, we, hereby testify that this application is being made on behalf of the above mentioned organization or business: *
I, we further testify that I, we are authorized to file this application on the organization’s behalf: *
I, We testify that the above information is current and accurate to the best of our knowledge: *
Signature from organization's president/chairman/owner: *
Date *
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Signature from organization's secretary: *
Date: *
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Submit
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