NICC Program Registration ~ MOHID ©

Noor Islamic Cultural Center - American Islamic Waqf

5001 Wilcox Road, Dublin, Ohio 43016, USA

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Registration Open

Noor All Stars Middle School Basketball

06
SEP

10:00 AM

13
DEC

12:00 PM

NICC Program Fee:

One Time: $40.00

Offering Days: Saturday

View Details

Reserved Seats: 6/25

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

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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 Noor Islamic Cultural Center - American Islamic Waqf consent to authorize electronic fund transfer from the account specified for this transaction in the amount specified.

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Payment Summary

NICC Program Fee

Total Registrants

Total Cost

Noor Islamic Cultural Center - American Islamic Waqf

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Noor All Stars Middle School Basketball

1 Contact Information

2 Add Registrants

3 Payment

Payment Methods

Or

Payment Summary

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