Skip to content
Facebook
Twitter
YouTube
Instagram
Contact Us
|
Events Calendar
|
Business Directory
|
Prayer Calendar
DAR AL-HIJRAH ISLAMIC CENTER
GIVE NOW
Home
About Us
History
Constitution
Leadership
Vision & Mission
What We Offer
Acknowledgements & Recognition
Departments
Outreach
Media/EPK
Masjid Etiquete
Family Care Committee
Social Services
2018 Winter Report
Community Assistance Programs
Monthly Urgent Appeals
Food Bank
Thrift Shop
Community Health Day
Friends Over 50
Safe Haven
Zakat Al-Fitr
Self-Sufficiency
English as Second Language (ESL)
Sewing Academy
Computer Learning Center
Job Resources Fair
Empowerment
CPR Certification
Weekend School
Youth
We’re Hiring
Weekly Programs
Rising Souls
Special Programs
Youth Conference
Mic Night 2018
Summer Camp
Women’s Programs
Muslimah Fest
Women’s Leadership Summit
Washington International Academy
Imam Corner
Counseling
Programs Offered
Classes Offered
Marriage Procedures
Divorce Procedures
Resources
Statements by the Board
Events Calendar
Business Directory
Prayer Calendar
Forms
Reports
Matrimonial Service
Funeral Service
Get Involved
Become a Member
Volunteer
Give
New Programs
Grow n’ Learn
Hanooti Academy for Quran
Playground Fund
Bathroom Renovation
Search for:
Membership Application
Home
/
Resources
/
Forms
/
Membership Application
Membership Application
ahaddam
2018-05-16T19:54:49+00:00
Step 1 of 5 - Head of Household Information
0%
Please Note:
The membership application will not be processed until the appropriate fees are paid.
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darrussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
Phone
*
Email
*
Enter Email
Confirm Email
Status
*
Married
Widowed
Single
Spouse Name
First
Last
Adult Family Member(s) (ages 18 & above)
Name
Gender (M or F)
Children under 18 years of age
Name
Gender (M or F)
First Reference
*
First
Last
Phone
*
Second Reference
*
First
Last
Phone
*
Membership Type
*
Individual
Couple
Membership Plan
*
Life
Annual
Membership Plan
*
Life
Annual
Additional Family Members
Price:
$60.00
Quantity:
Additional Family Members
Price:
$500.00
Quantity:
Additional Family Members
Price:
$60.00
Quantity:
Additional Family Members
Price:
$500.00
Quantity:
Total
$0.00
Add a Donation
not at this time
$1,000
$500
$250
$100
$50
$25
other
Enter a donation amount
Total
$0.00
How would you like to pay?
Pay by Credit Card now
Pay in-person
Rules & Regulations:
Applicant must be a Muslim who is 18 years of age or older.
Applicant must be a resident of Washington DC Metropolitan Area.
Applicant and any additional family members must enclose a photocopy of driver licenses and/or State ID.
In event of a change of address, member will notify Dar Al Hijrah Islamic Center of the new address within 30 days.
Applicant agrees to abide by the constitution of Dar Al Hijrah Islamic Center.
Applicant by signing the application, agrees to release Dar Al Hijrah Islamic Center, its Directors, Officers, Employees, and Agents from any claims, demands of action applicant may have against Dar Al Hijrah as a result of omission, rejection, suspension, or termination of applicant’s membership.
Credit Card
American Express
Discover
MasterCard
Visa
JCB
Maestro
Card Number
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
Expiration Date
Security Code
Cardholder Name
I have read and accepted the Dar Al Hijrah Policies associated with this application
