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Membership Form

Islam is peace, islam is justice, islam is humanity

New Membership form

“There are many educated people who have ruined their future on account of their ignorance of religion. Their knowledge did not prove of any avail to them.”
— Imam Ali (as)

Be the Shia of Ali(as), Play your role in the future of our community center, help our children understand our faith and direct them towards the right path for the success in this world and the hereafter. Save their future. You will also be able to vote in the election of executives, attend AGM and express your queries/concerns about day to day running of the Imambargah.

Requirements

  • Please make sure to fill up your contact details correctly.
  • we will contact you once your request is processed for further steps.
  • we would expect to know you in person.
  • * Next to the field name, are mandatory details.
  • You are required to provide reference of 3 active members. If you don’t have that information, please visit us at the center.
  • Please begin with selecting membership type to see appropriate form.

    Membership Type*:

    PRIMARY APPLICANT INFORMATION

    Title*:

    First Name*:

    Last Name*:

    Age*:

    Email*:

    Mobile*:

    Occupation:

    Qualification:

    ADDRESS & CONTACT INFORMATION

    Address*:

    City*:

    Postal Code*:

    Home Phone:

    SPOUSE INFORMATION

    Title:

    First Name:

    Last Name:

    Age:

    Email:

    Mobile:

    CHILDREN(UNDER 18) INFORMATION

    No. of Children:

    Name:

    Age:

    Name:

    Age:

    Name:

    Age:

    Name:

    Age:

    Name:

    Age:

    Name:

    Age:

    REFERENCES INFORMATION

    Active Member Name*:

    Phone*:

    Active Member Name*:

    Phone*:

    Active Member Name*:

    Phone*:

    As per Hussainia’s Constitution Article 6, Section 2, Active Member, is a Shia Ithna-Ashari Muslim with Fiqah-e-Jafaria ideology of practices, who has been in good standing (in dues) for minimum period of two consecutive years. An aspiring new member must be nominated by 3 Active members.


    *Every individual who wants to become Hussainia’s active member must have to get the following section filled by contacting 3 current active members of the Association*

    Additional Information

    If you like to Download Membership Form to fill up on paper, Please download, print, fill-up and bring the filled form to Hussainia. Please contact one of the executives.

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