World Islamic Mission Canada
 MEMBERSHIP FORM

 Home            Please use this form to (i) apply for membership (ii) update your personal information in our database or (iii) send us your comments


Information submitted for new membership update information (change of address or phone #)

First name*                                       Last name*
       

Street*                                                                                  Apt
     

City*                                                      Postal code*        Prov*.              Country
               

Email address*                                                    Tel #:
  
* Denotes mandatory information required

Comments:

Please send me notices of all up-coming events by email or bynewsletter
 Please send me more information on your Islamic Centre project and services offered
I would like to volunteer some of my time to your cause

All information provided to World Islamic Mission Canada is kept strictly
confidential for the purpose of staying in touch with our membership by
our office.  JazakAllah khair.