Dear Sir(s),

 I wish to become a member of the foundation and to abide by the MFI’s constitution and by-laws approved by the Board of Directors.

First Name                   Last Name   

Female   Male

Address                            

Address (line 2 if needed)

City                  State                 Zip    

Telephone  Numbers (without dashes)

Email      

MEMBERSHIP

   I agree to pay US $ 100.00 as a payment for the annual membership fee.

DONATION (OPTIONAL)

I enclose US $ 

Check here if the donation is towards Khums

Donation Purpose

Masjid Construction     General Donation

Donation Comment (optional)         

MONTHLY PLEDGE (OPTIONAL)

I agree to make recurring monthly contributions of (somebody from MFI/Masjid-e-Ali will be contacting you to set up the monthly payment towards the pledge):

None $ 25       $ 50      $ 75       $ 100       $ 150       $ 200     Other  

METHOD OF PAYMENT (for Membership and/or Donation)