ICBC Membership Form
Please complete one form for entire family.

Please review the membership requirements documented in the ICBC Constitution and Bylaws.
http://icbrushycreek.org/wp-content/uploads/ICBC_Constitution.pdf

Membership fee is $100 per family per calendar year, payable by either cash or check (please make checks payable to ICBC). The fee is due by Sept 1 of each year. Only one membership fee is required for all individuals living at the same address. The membership fees are used for Masjid Operations.”

To participate in ICBC Shura Council Election, a completed membership form needs to be submitted a minimum of 90 days before the election date.

If you have any questions, please email: membership@icbrushycreek.org, or call 512-850-4786.

Islamic Center of Brushy Creek
1950 Brushy Creek Road, Cedar Park, TX 78613 | http://icbrushycreek.org

Full Name *
Your answer
Spouse's Name (if applicable)
Your answer
Current Home Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Mobile Phone *
Your answer
Home Phone
Your answer
Spouse’s Phone (if applicable):
Your answer
Email Address *
Your answer
Spouse’s Email Address (if applicable):
Your answer
Subscribe to Email List: *
Required
Subscribe to ICBC Text Message Service *
Required
How many other people are in your household: *
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