Connect with the Office of the President
This form helps us stay connected and build meaningful relationships. Please share your information and any ways we can collaborate.
Name:
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State
Zip Code
Organization / Institution Name
Your Role / Title
Where did we meet?
*
Conference/Event/Masjid
Areas of interest / collaboration
Please Select
Education
Community Development
Youth Programs
Chaplaincy
Research
Other
Anything you’d like the President to know about you, or do you have any questions or topics you’d like to discuss?
Would you like to request a meeting?
Yes
No
Preferred meeting format
Virtual
In-person
Preferred timeframe
Within 2 weeks
Within a month
Flexible
*
I agree to receive emails from TISA for the purpose of receiving news and updates.
SUBMIT
Should be Empty: