Program Registration ~ MOHID ©

Easton Phillipsburg Muslim Association

1017 Lehigh Street, Easton, Pennsylvania 18042, USA

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EPMA Iteqaf Registration 2026

10
MAR

19
MAR

Program Fee:

One Time: $0.00

View Details

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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 Program

+ 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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Payment Methods

Or

Google pay Apple pay Credit/Debit Card eCheck/ACH

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 Easton Phillipsburg Muslim Association consent to authorize electronic fund transfer from the account specified for this transaction in the amount specified.

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Payment Summary

Program Fee

Total Registrants

Total Cost

Acknowledgement

Salaam,

By registering , you acknowledge that you will follow all the instructions provided to you by the Masjid for your and other community member's safety you waived any liabilities to the EPMA or its officers.

Jazakallah khair EPMA Management

Easton Phillipsburg Muslim Association

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EPMA Iteqaf Registration 2026

1 Contact Information

2 Add Registrants

3 Payment

Payment Methods

Or

Payment Summary

Acknowledgement

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