In the Name of Allah

The Beneficent, The Merciful

And keep up prayer and pay the poor rate and
offer to Allah a goodly gift and whatever good
you send before you and your soul's, you will
certainly find it with Allah, better and greater
in reward. "{73 - 20}
MEMBERSHI P APPLI CATI ON
APPLICANT INFORMATI ON
Please Select Member Masjid: MAR Watts, Los Angeles MAR2 Fifth Ward, Houston MAR3 Englewood, Chicago
Membership type: Individual Family Supporter Gender: Male Female
Name:
Date of birth: Age: Phone:
Current address:
City: State: ZIP Code:
FAMILY INFORMATION (IF APPLI CABLE)
Spouse Name:
Children: How many:
Name: Male Female Age:
Name: Male Female Age:
Name: Male Female Age:
Name: Male Female Age:
Name: Male Female Age:
MEMBERSHIP (TAX DEDUCTIBLE) DUES
Full Membership Dues: (Please Fill-in & Check one) For Auto Deductions, please contact a Masjid Director.
Individual: $10/month, or $30/quarter or $120/year
Family (2 or More): $20/month, or $60/quarter or $240/year
SUPPORTER (TAX DEDUCTIBLE) DONATIONS
(Please Fill-in & Check one)
Auto Deductions $______ /month, (contact a Director for details) One-time Supporter $_________
Regular Supporter $______ /month, or ______ /quarter or ______ /year
AVAILABLE TI ME FOR VOLUNTEER WORK
How many Hours per week
are you available for
Volunteer work? _________
What Time Periods are you
Available for Volunteer Work?

(Please Check Time Period)
M T W Th FR Sat Sun
6 am 9 am
9 am 12 pm
12pm 3 pm
3 pm 5 pm
5 pm 8 pm
8 pm 11 pm
SIGNATURES
I hereby affirm that the above-mentioned information is correct to the best of my knowledge and I will abide by the policies of
MASJ I D AL-RASUL NO. 2
Signature of applicant: Date:
Signature of spouse (only if for a joint membership): Date: