ISAK Educational Programs Registration ~ MOHID ©

Islamic Society of Akron and Kent

152 E Steels Corners Rd., Cuyahoga Falls, Ohio 44224, USA

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ISAK FALL BAZAAR

13
SEP

12:00 AM

26
SEP

12:00 AM

ISAK Educational Programs Fee:

One Time: $50.00

Offering Days: Monday, Tuesday, Wednesday, Thursday, Friday, Saturday, Sunday

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1 Contact Information

First Name *

Last Name *

Phone Number *

Email Address *

Address1 *

Address2

Country *

State *

City *

Zip Code *

Cell Number

2 Add Registrants

Primary Contact as First Registrant

Registrant Name*

Email Address

Age

Gender

Choose ISAK Educational Programs

Vendor Name or LLC*

Address:*

Email Address*

Mobile Number:*

Type of Good and Service*

Please share additional details about your setup

+ Add More Registrants

3 Payment

Monthly Recurring

Recurring Start Date*

Number of Months*

For Lifetime

Please note: You will incur a $1 charge if the recurring start date is not current date in order to verify the payment details provided. This charge will not be credited back to your account and you will receive a test transaction receipt for this amount.

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Since you purchased free Ticket No Payment Required.

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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 Islamic Society of Akron and Kent consent to authorize electronic fund transfer from the account specified for this transaction in the amount specified.

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Payment Summary

ISAK Educational Programs Fee

Total Registrants

Total Cost

Islamic Society of Akron and Kent

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ISAK FALL BAZAAR

1 Contact Information

2 Add Registrants

3 Payment

Payment Methods

Or

Payment Summary

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