Become a Member - Al-Madina Association

Member Info

Pledge Info

Summary

Member Information

Please fill in your personal details below.

First Name *

Last Name *

Email Address *

Phone (Home)

Phone (Cell) *

Address *

City *

State *

Zip Code *

Membership Pledge

How would you like to support Al-Madina Association?

Pledge Amount ($) *

Payment Frequency

Now (One-Time) Monthly Quarterly Yearly

Payment Method

Cash Check Direct Deposit Other

Signature

Full Name (Signature) *

Date *

Please make checks payable to: Al-Madina Association. Mail to: 2058 Bonaire Path W, Rosemount, MN 55068.

Summary & Confirmation

Please review your information before submitting.

Member Information

Full Name

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Phone (Home)

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Phone (Cell)

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Address

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Pledge Information

Pledge Amount

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Frequency

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Payment Method

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Date

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Signed By

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JazakAllah Khair!

Your membership application has been received. We will be in touch at the email you provided. May Allah accept it from you.

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