Program Registration ~ MOHID ©

Memphis Islamic Center MIC

10225 Humphrey Road, Cordova, Tennessee 38018, USA

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Registration Full

Food Truck Registration

26
OCT

2:00 PM

26
OCT

6:00 PM

Program Fee:

One Time: $100.00

Offering Days: Sunday

Reserved Seats: 9/9

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

Food Truck/Business Name*

Type of Cuisine/Menu*

Length of Food Truck (To Allocate Space Needed)

+ Add More Registrants

3 Vendor Fee

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.

Promotion Code Promotional Price Applied

Since you purchased free Ticket No Payment Required.

Comments

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 Memphis Islamic Center MIC consent to authorize electronic fund transfer from the account specified for this transaction in the amount specified.

Agree Decline

Payment Summary

Program Fee

Total Registrants

Total Cost

Acknowledgement

By registering, you acknowledge that you will follow all the instructions provided to you by the Masjid mentioned below. - Limited availability ~4 spots - Deadline to sign up Wednesday October 15th.

Memphis Islamic Center MIC

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Food Truck Registration

1 Contact Information

2 Add Registrants

3 Vendor Fee

Payment Methods

Or

Payment Summary

Acknowledgement

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