New Application for the Visionary Leadership Award

Application for the Visionary Leadership Award

in the Tradition of the Prophet Muhammad (PBUH)
Name *

First Name Middle Name Last Name
Are you applying as an individual or representative of an organization? *

Individual Representative of an organization
If applicable, name the organization that you represent
Would you like to be considered for the IRUSA Black/African American Muslim Scholarship?

Yes No
Applicant Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Email *
example@example.com
Date of Birth *
Gender *
Select your highest level of education *
There is no particular level of education required for this reward.
Please give a brief description of your Islamic education and training outside and inside the US *
Please upload your CV or email it to info@islamicseminary.us with the subject "Visionary application." *

Browse Files

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Please give a brief description of your general education and training outside and inside the US *
Please list all of your paid and volunteer services performed in the Muslim Community and outside of the Muslim Community. *
Please provide 3 character references, including their name, relationship, phone, and email. One reference must be someone from outside of the Muslim community.
Reference: 1 *
Reference 2 *
Reference 3 *
Please submit a 300 to 650-word essay below on what your vision is of the future of Islam in the US and why you should be a part of this leadership development program. Please note that this program includes a particular focus on building leadership capacity for women and those who serve economically stressed communities.
Date

Month Day Year
Date
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