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Basic Information

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Membership Fee Type: *

Membership Period: *

Personal Information

First Name: *

Last Name: *

Company Name:

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Other Information

Date of Birth:

Gender:

Marital Status:

Family Membership $200 and Individual Membership $100. Membership applications are reviewed at monthly board meeting. Dues are assessed after approval.

Spouse:

Child 1(15+):

Child 2(15+):

Child 3(15+):

Child 4(15+):

Reference 1 (Name and #):

Reference 2 (Name and #):

Spouse Email:

Contact Information

Address1: *

Address2:

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Cell Number:

Email Address: *

Native Country:

Declaration

I Accept: *

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Membership Details

Start Month: January 2019

Membership Start Date: 01/01/2019

Membership End Date:

Start Month: January 2019

Membership Start Date: 01/01/2019

Membership End Date: 12/31/2021

Start Month: January 2021

Membership Start Date: 01/01/2021

Membership End Date: 12/31/2023

Declaration

I am a Muslim and attest that there is no God but Allah and Muhammed is the seal of the prophets (peace be upon him) and I ascribe to the teachings of the Holy Quran and Sunnah as understood by Ahlus Sunnah Wal-Jama'ah.

Muslim Community Association of Ann Arbor

Ann Arbor

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Declaration

Masjid Support

Muslim Community Association of Ann Arbor