IEC Membership Form
Please complete the below membership form. For family membership, please complete only one form per household.
Full Name *
Email Address *
Primary Phone Number *
Secondary Phone Number
Gender *
Address
Street, City, State, Zip Code
Occupation
Spouse Name
Child Information
For programming and madressah purposes, please list your child's Name, Gender, and Age. For multiple children, please separate by using ;
Any skills, or services you posses
Please list any skills or services you are able to provide for the benefit and betterment of the community
Membership Type *
Setup reoccurring membership due payments by visiting http://iecoforlando.org/index.php/donate/ or contacting bod@iecoforlando.org
By checking the below, you confirm you will abide by, and uphold the duties of a member in accordance with the By-Law's of IEC of Florida Inc. *
Required
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