MOMIN Membership Application

Metroplex Organization of Muslims in North Texas

Reg. No. 75-2251188

P.O. Box 142763 Irving, Texas 75014-2763

Voice: +1 (972) 554-0200

http: //www.momin.org

2945 Frankford Rd, Dallas, TX 75287

MEMBERSHIP APPLICATION FORM
Metroplex Organization of Muslims in North Texas (MOMIN) is the oldest Shia organization in the Dallas Fort Worth Area. MOMIN was formed in 1988 by a handful of families who realized the need for an Islamic Center back then. Today Alhamdolillah MOMIN caters to the spiritual and social needs of more than 600 families.
Type of Membership*

Individual ($300 Annual)Family (Husband and wife) ($600 Annual)
Member Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*

MaleFemale
Occupation*
Education*
Cell Number*
Please enter a valid phone number.
Email*
example@example.com
Upload your picture

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Member Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*

MaleFemale
Occupation*
Education*
Cell Number*
Please enter a valid phone number.
Email*
example@example.com
Upload your picture

Cancelof
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Zipcode

REFERENCES OF TWO CURRENT MOMIN MEMBERS
Recommended by 1*

First NameLast Name
Cell Number*
Please enter a valid phone number.
Recommended by 2*

First NameLast Name
Cell Number*
Please enter a valid phone number.
Add Cell number to MOMIN WhatsApp group for program and event announcements

Yes
Subscribe to MOMIN emails and Community emails

Yes
Membership Fees
I declare that

La ilaaha illal-Laah; Muhammadur Rasulul-Laah; Aliyun waliyul-Laah wasi-yu-Rasulil-Laah; wa Khalifatuhu bila fasl.

There is no god but Allah, Our Prophet Hazrat Muhammad Mustafa (S.A.W.) is the Messenger of Allah, Ali (A.S.) is the Wali (beloved) of Allah. Imam Ali (A.S.) is the successor of the Prophet. And he is the First Khalifa of the Prophet.

I understand that : registered member must pay the applicable membership fees, fill out a membership form and keep membership information updated with the General Secretary generalsecretary@momin.org in case of any change.

Annual Membership fee is due on the first day of each calendar year.

Any registered member who has not paid their annual membership fees for two consecutive years, automatically terminates the membership as a registered member
Signature*

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Annual Membership Fee

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