MAJ - Janaza Services Request form

JANAZA SERVICES

Request form
Contact Infomation

For In-Town Janaza

1. Br. Adam Jahankeer - 416-885-1806

2. Br. Shiraz Mohideen - 416-522-4645

For Out of Town Janaza

1. Br. Zubair Mahmood - 416-844-3817

2. Br. Adam Jahankeer - 416-885-1806
Janaza type*

In TownOut of Town (Ghaib Janaza)
Will you have a Ghaib Janaza prayer?*

YesNo
Ghaib Janaza prayer location?*

Masjid Al JannahElsewhere
Do you want email / whatsapp notifications sent?*

YesNo
Name of submitter*

First NameLast Name
Phone Number of submitter*
Please enter a valid phone number.
Relationship to deceased*
Address*

Street Address

CityProvince

Postal CodeCountry
Email*
example@example.com
Details of the deceased
Name of deceased*

First NameLast Name
Date of death*

MonthDayYear
Date
Place of death*
Location and address of Janaza prayer*
Date and time of Janaza prayer*

MonthDayYear
Date
Hour MinutesAM/PM Option
Janaza viewing time*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Who will conduct the Janaza prayer*
Ghaib Janaza details
Date of Ghaib Janaza prayer*

MonthDayYear
Date
Time of Ghaib Janaza prayer*
Location of Ghaib Janaza prayer*
Who will conduct Ghaib Janaza prayer*
Time of Ghaib Janaza prayer*
Additional relatives details of the deceased*
Any other details*
Signature of submitter*

Clear
By signing this form I absolve MAJ of any errors or omissions in communication due to misinformation provided by the submitter of this form. I also acknowledge that I have been permitted by the family to provide this information to MAJ.
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JANAZA SERVICES