Membership Form

Please complete the form during the annual Membership Window (1st January to the last day of February).

Applications submitted outside this period will not be valid.

Note: You must provide proof of identity and address with payment for the relevant subscription fee for the application to be valid.

You will receive an email copy of your submission to confirm your membership. Please check your junk/spam folders.

If your application requires clarification or additional information, we will contact you accordingly.

Membership Type

Full Name

Email Address

Address

Post Code

Upload to or

Telephone Number

Upload proof of identity/address

Drag & Drop Files, Choose Files to Upload You can upload up to 10 files.

Please tick the boxes below to confirm the following:

I am aged 16 or over

I accept and agree to abide by the Constitution of Jamiat Ittihad-Ul-Muslimin

I agree to receiving notice of meetings and other relevant communications by e-mail.

I agree to receiving notice of meetings and other relevant communications by e-mail.

The information provided in this form is true and accurate.

Print Name

Signature

Clear Signature

Date

I'd like to help cover the transaction fees for my donation

Your Payment Details

Total

Item Quantity Qty Total

There are no products selected.

Membership Fee (Lifetime Member) 1 £1,000.00

Membership Fee (Ordinary Member) 1 £20.00

Additional Fee 1 £1.00

Additional Fee 1 £12.50

Total £0.00

Form Submission Date