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Registration

 

For YOUTH REGISTRATION CLICK HERE


PLEASE HIGHLIGHT AND PRINT THIS REGISTRATION FORM TO FILL OUT AND MAIL TO WCMAS WITH YOUR PAYMENT OR PAY ONLINE .

Registration Form

____ Yes!  Insha'Allah, I plan to attend.                             

____ No.  I can't attend, masha'allah.

____ No.  I can't attend, but please accept the enclosed donation, alhamdullillah.

Name:__________________________________________________________

Address:________________________________________________________

City:_______________________________ State:______ Zip:______________

Phones: (H) ________________________

(C) __________________________

E-mail address: ___________________________________________________

Please indicate your choices for lunch and dinner entrees:

 

Lunch:

Herb Seared Chicken Breast                                   

Tilapia with Tomato Chutney             

Vegetable Lasagna

Dinner:

Herb and Oil Infused Chicken Breast

Baked Salmon

Vegetarian Mediterranean Purse


Method of Payment

____ Enclosed is my full payment for registration

0$90*   0$100  0$125

*Early Bird Special $90 price must be paid in full by

October 31.

0Please set up a monthly payment plan

 Enclosed is my initial deposit of $40

 

 

 

0check                 0money order

1st payment of $40 due by Jan.  28, 2014

2nd payment of $30 due by Feb. 28, 2014

3rd payment of $30 due by Mar. 28, 2014

Today’s date:_____________________________

 Make all checks or money orders payable to

WCMAS and mail to the address  below.

 

Women’s Committee of Masjid As-Saffat

1335 W. North Avenue

Baltimore, MD 21217

 

 

 

 

EACH ATTENDEE MUST COMPLETE A SEPARATE FORM

 Are you registering for the youth conference? If yes, click here for a special youth registration form.

 

 

 

 

 

 
 
 

Click Here to download a 2014 registration form in PDF Format.