Hampton Roads Zakat Request
This is for you or someone you know that needs Zakat. We will contact this phone number or email to process the request.
Name
First Name
Last Name
E-mail
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of dependents
Employment status
Masjid you frequent the most
Additional Information:
Are you an employee of Crescent Community Center?
*
Please Select
Yes
No
Are you a relative of an employee/board member?
*
Please Select
Yes
No
Are you affiliated with any elected official?
*
Please Select
Yes
No
Is this a political donation?
*
Please Select
Yes
No
Is this payment in exchange for any services or volunteer work performed on behalf of Crescent Community Center?
*
Please Select
Yes
No
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