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Jame Masjid Mississauga - Islamic Propagation Centre of Ontario

5761 Coopers Ave, MISSISSAUGA, Ontario L4Z1R9, CA

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Foundation of Islam - Crash Course

13
JAN

28
JUN

Program Fee:

One Time: $120.00

Monthly: $20.00 (Number of Months: 6)

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1 Contact Information

First Name *

Last Name *

Phone Number *

Email Address *

Address1 *

Address2

Country *

Province *

City *

Postal Code *

Cell Number

2 Add Registrants

Primary Contact as First Registrant

Registrant Name*

Email Address

Age

Gender

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3 Payment

Payment Method

Credit/Debit Card

Name on Credit Card *

Credit Card Number*

Expiry Date*

CVV Code*

Bank Name

Name on Account *

Account Number*

Routing Number*

Account Type*

Monthly Recurring

Recurring Start Date*

Number of Months*

For Lifetime

Please note: You will incur a $1 charge if the recurring start date is not current date in order to verify the payment details provided. This charge will not be credited back to your account and you will receive a test transaction receipt for this amount.

Consent * Do you give Jame Masjid Mississauga - Islamic Propagation Centre of Ontario consent to authorize electronic fund transfer from the account specified for this transaction in the amount specified.

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Payment Summary

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Acknowledgement

By registering, you acknowledge that you will follow all the instructions provided to you by the Masjid for your and other community member's safety

Jame Masjid Mississauga - Islamic Propagation Centre of Ontario

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Foundation of Islam - Crash Course

1 Contact Information

2 Add Registrants

3 Payment

Payment Summary

Acknowledgement

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