Family Registration For Purified
Assalaamu Alaikum Seeker of Knowledge,

Qabeelat Wasat will be offering a family discount to help pay for the seminar, in sha Allah.

The discounted cost is:
$75/ person for 3 members
$65/person for 4 members
$60/person for 5 members or more

There are two simple steps to apply:

1. Fill out this form and submit it by JANUARY 1st, 2019
2. Respond to the email from Wasat Finance by August 5th and follow any instructions outlined in the email.

Please remember:

- Please fill out the form only once.
-Each individual will need to register for the class online at www.AlMaghrib.org/Chicago with his or her own email address.

Please do not hesitate to contact us with any further questions. JazakumAllahu khairan.

Ziyad Dadabhoy (ameer.wasat@almaghrib.org)
Jawairiya Rasool (ameerah.wasat@almaghrib.org)
Biann Abu-Elreish (wasat.finance@almaghrib.org )

First Name *
Your answer
Last Name *
Your answer
Email address (specifically the one you will use to register for the class) *
Your answer
Gender *
Family member 1 Info (include first and last name, gender, and email)
Your answer
Family member 2 Info (include first and last name, gender, and email)
Your answer
Family member 3 Info (include first and last name, gender, and email)
Your answer
Family member 4 Info (include first and last name, gender, and email)
Your answer
Family member 5 Info (include first and last name, gender, and email)
Your answer
Family member 6 Info (include first and last name, gender, and email)
Your answer
Family member 7 Info (include first and last name, gender, and email)
Your answer
Family member 8 Info (include first and last name, gender, and email)
Your answer
Questions or comments?
Your answer
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