EPIC - JotForm URL Request
Requester Name
*
First Name
Last Name
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Committee or Program Name
*
Approved By
*
Please Select
Amir Manzoor
Asher Khan
Baseer Syed
Md Abdul Kalam Azad
Rashid Azme
Sameer Siddiquie
Yahya Sheikh
Does your form requires any payment capture option?
*
Yes
No
Provide Payment Amount and Details?
Specify the amount and the EPIC account (Operations/Qalam/Sadaqa etc.) will be linked to.
Form Title
*
Need the Form created by:
*
-
Month
-
Day
Year
Please provide up to 48 hours lead time
Event Venue
*
Location, Room and Time
Form Details
*
Provide content and fields you would like to add on the form.
Document Upload
Browse Files
Drag and drop files here
Choose a file
Upload supporting contents, flyer etc.
Cancel
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The program must be approved by the board liason prior to making the Jotform request.
All reservations must be submitted in writing and are subject to approval by the facility management.
The undersigned organization agrees to release, waive, and hold harmless East Plano Islamic Center, its officers, directors, employees, volunteers, and affiliates from any and all claims, liabilities, damages, or losses—including, but not limited to, those related to personal injury, property damage, or theft—that may arise from or be in any way connected to the use of the facility.
Please verify that you are human
*
Submit
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