New Membership ~ MOHID ©

Please use Member portal to renew your membership if you are an existing member.

Primary Member Infomation

First Name *

Last Name *

Phone Number *

Email Address *

Confirm Email Address *

Company Name

Date of Birth

Gender

Address1

Address2

Country

State

City

Zip Code

Citizenship Type

US Citizen Not a US Citizen

Marital Status

Add Family/Group Information

Group Member Type *

First Name *

Last Name *

Phone Number *

Email Address *

Confirm Email Address *

Company Name

Date of Birth

Gender

Same as Primary Member

Address1

Address2

Country

State

City

Zip Code

Citizenship Type

US Citizen Not a US Citizen

Marital Status

+ Add Another Family/ Group Member

Membership Type *

About Membership:

Do you want to signup membership for your family members too?

Yes No

In case of No, only primary member will be enrolled in selected membership type.

Select Membership Duration

Membership Period(s) Membership For Lifetime

Membership Start Date:

Membership End Date:

Membership Join Date: 11/04/2026

Membership Fee Type *

Before submission, please review the provided information to avoid typing mistakes.

Member(s) Information:

Name	Phone	Email	Address	Relation	Gender	Date of Birth	Marital Status	Native Country	Citizenship Type

Children Detail(s):

Name	Phone	Email	Year of Birth

Membership Detail(s):

Membership Type:

Validity:

Membership Start Month	Membership Join Date	Membership End Date

Fee Detail(s):

Fee Type	Fee Amount Per Member	No. of selected Periods

Amount Per Member For Selected No. of Periods	Total Members	Total Amount Due

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Comments

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Payment

Monthly Recurring

Recurring Start Date*

Number of Months*

For Lifetime

Recurring Information

Note: Monthly recurring amount is calculated by dividing the Amount Due with Number of Months.

Promotion Code Promotional Price Applied

Total Amount Due

Amount Paying

Payment Methods

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Name on Credit Card *

Credit Card Number*

Expiry Date*

CVV Code*

Bank Name

Name on Account *

Account Number*

Routing Number*

Account Type*

Consent * Do you give Support-Masjid Usman Ghani consent to authorize electronic fund transfer from the account specified for this transaction in the amount specified.

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Primary Member Infomation

Declaration

About Membership:

Member(s) Information:

Children Detail(s):

Membership Detail(s):

Validity:

Fee Detail(s):

Payment

Payment Methods

Or

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