New Membership Application Form

Full Name

This address will receive a confirmation email

Phone

Profession/Field of Work (Please be specific)

Do you consent to participate in the online community directory by sharing your name, phone number and email address ? (Please Note: if you do not consent, then you will not have access to the online community directory)

Yes No

Year of Birth needed to confirm membership type (please select January 1 and the actual year of birth)

Membership Type and Monthly Fee (Note: No fee for children aged under 18 years)

Adult (age 26 - 64) - $20 monthly Senior (age 65 and over) - $12.50 monthly Youth (age 18 - 25) - $7.50 monthly

Full Name of Spouse

Spouse's Email

Spouse's Phone

Spouse's Profession/Field of Work (Please be specific)

Do you consent for your spouse to participate in the online community directory by sharing their name, phone number and email address ? (Please Note: if you do not consent, then they will not have access to the online community directory) Yes No

Spouse's Year of Birth needed to confirm membership type (please select January 1 and the actual year of birth)

Membership Type and Monthly Fee (Note: No fee for children aged under 18 years) Adult (age 26 - 64) - $20 monthly Senior (age 65 and over) - $12.50 monthly Youth (age 18 - 25) - $7.50 monthly

Child 1 Age Under 18 - Name (First Name, Last Name)

Child 1 Age under 18 - Year of Birth needed to confirm membership type (please select January 1 and the actual year of birth)

Child 2 Age Under 18 - Name (First Name, Last Name)

Child 2 Age under 18 - Year of Birth needed to confirm membership type (please select January 1 and the actual year of birth)

Child 3 Age Under 18 - Name (First Name, Last Name)

Child 3 Age under 18 - Year of Birth needed to confirm membership type (please select January 1 and the actual year of birth)

Child 4 Age Under 18 - Name (First Name, Last Name)

Child 4 Age under 18 - Year of Birth needed to confirm membership type (please select January 1 and the actual year of birth)

Child 5 Age Under 18 - Name (First Name, Last Name)

Child 5 Age under 18 - Year of Birth needed to confirm membership type (please select January 1 and the actual year of birth)

Child 6 Age Under 18 - Name (First Name, Last Name)

Child 6 Age under 18 - Year of Birth needed to confirm membership type (please select January 1 and the actual year of birth)

Address

Total Monthly Membership Fee Amount $

Additional Monthly Donation Amount $ towards Centre Operating Expenses. You can make this donation with the intention of one or more Marhum / Marhuma. Jazak'Allah Khayran.

Total Monthly Membership Fee and Donation Amount $ (Withdrawals occur around 1st business day each month)

Please attach a picture of VOID Cheque or Bank Preauthorised Debit Account Information

Upload (8MB)

Signature of Applicant (Please type your name)

Signature of Spouse (Please type your name)

Date

Terms and Conditions

By signing this application, I/We agree to the Terms and Conditions below.

Terms and Conditions: Membership

1. By signing this application, I/We expressly agree to the use, collection and disclosure of the information provided herein by the Almehdi Almuntathar Union (Operating As Al-Mahdi Islamic Community Centre) to generally further the aims and objectives of the Almehdi Almuntathar Union, including, but not limited to, the use by subcommittees and special committees of the Almehdi Almuntathar Union. I/We agree to abide by the rules and regulations as laid down in the By-Laws of the Almehdi Almuntathar Union, including any amendments that may be made from time to time.

2. By signing above, I/We hereby apply for membership in the Almehdi Almuntathar Union. I/We agree to abide by the rules and regulations as laid down in the By-Laws of the Almehdi Almuntathar Union, including any amendments that may be made from time to time. I/We acknowledge that the approval of my application is subject to the approval of the Board of the Almehdi Almuntathar Union in accordance with the By-Laws thereof. Note: New member applicants must have a proposer and a seconder that are Members in good standing of the Almehdi Almuntathar Union. New member applicants must upon request also provide personal identification, proof of residency status, date of arrival information and any other information that the Almehdi Almuntathar Union may deem necessary.

3. I am/we are aged 18 or over.

4. I am/we are followers of the Jaffari School of Thought.

5. I am/we are or have been residents of London and surrounding areas.

6. The membership year follows the annual Islamic Calendar from Muharram to Dhul-Hijjah each year.

Terms and Conditions: Pre-authorized Debit Agreement

1. You acknowledge that the authorization is to allow Almehdi Almuntathar Union (operating as Al-Mahdi Islamic Community Centre) with whom your agreement is with to debit funds from your bank/credit union account for monthly payments based on your donation pledges to Almehdi Almuntathar Union.

2. You waive any legislative or regulatory requirement for pre-notification.

3. Transaction dates that fall on a weekend or holiday will be processed the next business day.

4. You understand this is a personal PAD agreement.

5. You may revoke your authorization at any time, subject to providing notice of 4 business days before the next scheduled debit. You can obtain a sample cancellation form or more information on your rights to cancel a PAD agreement at your financial institution or by visiting the www.payments.ca/paying-pre-authorized-debit. You can also reach out directly to Almehdi Almuntathar Union and cancel your authorization.

6. You have certain recourse rights if any debit does not comply with this agreement (because the debit was not withdrawn in accordance with this authorization or amounts were withdrawn after the agreement was revoked). For example, you have the right to receive reimbursement for any debit that is not authorized or is not consistent with this PAD agreement based on the timeline set out by the Canadian Payment Association. To obtain more information on your recourse rights, contact your financial institution or the Canadian Payment Association.

Please Provide Names of Your Membership Application Proposer and Seconder Below

In order to process your application, please provide two names of members of the Centre in good-standing (have paid their fees to date).

(Note: The Secretariat will directly confirm with them that they know you and that you are a follower of the Jaffari School of Thought)

Full Name of Your Membership Application Proposer

Full Name of Your Membership Application Seconder

THIS SECTION BELOW TO BE COMPLETED BY THE SECRETARIAT, ALMEHDI ALMUNTATHAR UNION

Proposer and Seconder Completion Verification Information (Proposer and Seconder Both in Good Standing and Know Applicant(s) to be followers of the Jaffari School of Thought)

Membership # Assigned After Board Approval

Member Information Status Updated in Breeze Centre Management System Member Type (also for spouse if applicable) Membership ID # (also for spouse if applicable) Membership Start Date (also for spouse if applicable) Membership Fees Paid to Date (also for spouse if applicable) Set up Annual Membership Pledge Amount under current Islamic Year

New Membership Application Form

Description

Please Fix the Following