DFW Islamic Center | Home

Home Member Registration

We are happy that you and your family have chosen to register with Nigerian Muslim Association - DFW Islamic Center as your faith community. Our greatest hope is that you find here what you and your family need to grow in faith at every age, stage, and circumstance of life. We invite you to form an ongoing relationship with the DFW Islamic Community by completing a registration form online or registration cards are available at the Masjid or you may print the attached form. Also, please advise the Masjid of any change of address or phone number.

Head of Household

First Name:

Middle Name:

Last Name:

Maiden Name:

Birth Date:

Occupation:

Cell Phone :

Email:

Spouse

First Name:

Middle Name:

Last Name:

Maiden Name:

Birth Date:

Occupation:

Cell Phone :

Email:

Common Information

Please make sure each field is filled out for our records.

Home Address:

Occupation:

Apt # :

City :

Zip Code:

Home Phone:

Children at Home

Please complete for each child living at home. If you have more children than the spaces provided, please contact the Masjid Executives

Child 1 First Name:

Middle Name:

Last Name :

Gender :

Date of Birth:

Child 2 First Name:

Middle Name:

Last Name :

Gender :

Date of Birth:

Child 3 First Name:

Middle Name:

Last Name :

Gender :

Date of Birth:

Child 4 First Name:

Middle Name:

Last Name :

Gender :

Date of Birth: