PAYMENT FORM
Mosque For The Praising of Allah, P.O. Box
190644, Roxbury, MA 02119
Email:
info@MosquePraiseAllah.com Phone:
617-442-4676
Website:
www.MosquePraiseAllah.com
The form can be used to mail
in payments for donation, membership, events and/or workshops.
Name:
Organization/Affiliation:
____________________________________________________
Street:
City:
State: Zip:
E-mail Address:
Tel:
________________________
Please select one or more
of the following items you want to pay for::
==============================================================
Item
Name: Get pricing from our website
Cost:
==============================================================
Masjid Annual Membership
$
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Masjid - Donation
$
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Class
$
Name of Class:
----------------------------------------------------------------------------------------------------------------------------
Event
$
Name of Event:
==============================================================
TOTAL AMOUNT ENCLOSED
$
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I agree to abide by the rules and regulations of the Masjid as implemented.
Signature:
__________________________________ Date:
-
Make check payable to "Mosque For
The Praising of Allah"
- Mail check and this form
to:
"Mosque
For The Praising of Allah, P.O. Box
190644, Roxbury, MA 02119".
- We will reply to you with confirmation, if you have not received a
confirmation within 25 days please contact us.
If you have any questions call us at Phone:
617-442-4676
OR use or credit card to pay on-line on our website:
www.MosquePraiseAllah.com
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