Membership Info

		Membership Info
	[Home] [Up] [Mission] [Contacts] [Contents] [Search]

Please fill in data to be added to our Membership Directory

Last Name
First Name
Job	ELI UG MS *PhD* *Professional* *Other*
Profession/Field
Affiliation
Home Phone
Cell Phone
Work Phone
E-mail
Listserv email List	*Already on List Please add me to list*
Read Arabic	*Yes No*
Address
City, State
Marital Status	Single Married
No of Children
	Child #1	Child #2	Child #3	Child #4
Child Name
Age
School

Monthly Donation	$
Religious/Intellectual Activities	Friday Night Tajweed Religious Circle Other
Social Activities of interest	Gatherings Picnics Potluck Other
Athletic Activities of interest	Soccer Volley Ball Basket Ball Other
Suggestions: (Please list activities you would volunteer to lead)

[Home] [Up] [e-Library (Links)] [Quran] [Articles] [Khutab] [MultiMedia] [Open House]
E-mail icb@islamview.org with questions or comments.
Last modified: 12/11/07