AMDA New Membership Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Membership Type *

Family Membership ($100 per year) - Applies if you are married

Individual Membership ($50 per year) - Applies if you are single (unmarried)

Associate Membership ($100 per year) for residents outside of Oakland, Macomb, St. Claire & Wayne Counties.

Required

If you have selected family membership please mention the number of the child/ren included in the family

First Name *

Last Name *

Spouse’s First Name

Spouse’s Last Name

Address (Street) *

Please make sure you use the same address when paying the membership in Paypal

Address (City) *

Address (State) *

Address (ZIP Code) *

Home Phone

Cell Phone

Email *

To receive email from AMDA email system you need to subscribe to the system separately by visiting www.amda.us. Please make sure you use the same address when paying the membership in Paypal

Heritage/Country of Origin(s)

To support AMDA’s objective of representative governance

Heritage/Country of Origin(s) - Spouse

To support AMDA’s objective of representative governance

Volunteer Preference: (AMDA encourages its membership to volunteer in any of its many activities. Please indicate which of the following activities you are interested for volunteering:)

Membership

Finance

Education

Facilities

Social Programs

Election Committee

Newsletter/Communication

Youth Activities

Da’wah/Interfaith

Library

Other:

Check-o-matic Information (Minimum $25 per month): Are you interested in a monthly Check-o-matic deduction for membership renewal fee or donation? *

Member’s Rights and Responsibilities:

Member’s rights, privileges, and responsibilities are described in detail in the constitution and in the by-laws of AMDA. Every applicant is encouraged to read the constitution before signing the application for membership. The constitution is available at AMDA website (www.amda.us).

Declaration:

I/We the undersigned hereby agree to abide by the constitution and by-laws of AMDA:

Applicant Signature *

Please put your email address as signature confirmation

Applicant Signature (Spouse)

Please put your spouse's email address as signature confirmation

Paypal Email Address *

Please put email address that you will use in PayPal for membership fees payment

Membership Fees Payment

After submitting the membership form you will be directed to a confirmation page with link to Paypal to submit the membership fees. Please use that link to submit your membership fees. Once we receive the membership fees and the membership is approved, InshaAllah we will send you an email notifying you of the application status.

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms