Main Attendee
     
[Fields marked with * indicate required fields]
First:*
Last Name:*
Age:
Female Male*
Program planning to attend:*
I'm a College Student I'm a Senior Citizen

[ID required onsite]
Address:*
City:*
Country:*
   
State:*
Zip Code:*
Phone:*   Format: 000-000-0000
Fax:
Email:* [to get confirmation]
Profession:
How did you hear about the convention this year?

 

Dependents / Group Members
 Program: Daycare 0-4 Yrs Old           School: 5-9 Yrs Old        Young Youth: 10-14   
                    Youth: 15-17 years Old      Main: 18 Yrs old and up
Category* First Name* Last Name* Age Gender* Program*

[Child: 9 years and under. Young Youth: 10-14 .  Youth: 15-17 years. Adult: 18 years and up]
Please list any special handicap needs:
 
Registration Cost   (Refresh page and refill - if cost is not totaling)
Description Amount Number of Attendees Subtotal
       
TOTAL REGISTRATION COST  
Help support Islamic work with your tax-deductible donations.  As mentioned by several prominent scholars, your donation maybe considered as part of your ZAKAT.
Donation: $
[Registration + Donation] GRAND TOTAL: $0
 
* Required fields

      
   

Cancellation Policy: Registration canceled before December 1st is subject to 20% service charge. Registrant who fails to attend or contact Registration Office to cancel by December 1st will be liable for the entire fees. Convention management has the right to deny any person from attending without any liability.