Member Registration

    Name
    Email Address
    Current Address
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    Postal Code
    Phone (Home)
    Phone (Cell)
    Phone (work)
    Fax
    Current Profession
    Specialization


    Spouse Information (if applying for family membership)

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    Please provide two references below.

    Name
    Email
    Phone


    Declarations (circle appropriate response)

    I am a Muslim over the age of 18
    YesNo
    I am Permanent resident OR Citizen of Canada(Will provide proof upon request)
    YesNo
    I am living in Saskatchewan for at least six months(Will provide proof upon request)
    YesNo
    I will abide by the constitution and By-Laws of IAOS Regina Inc.
    YesNo
    I am not a member of any other Islamic Organization in Saskatchewan
    YesNo


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    By clicking submit you are agreeing to pay one of the following membership fee.

    Membership Fee
    Monthly $20 Individual
    $40 Couple
    Annual $240 Individual
    $480 Couple


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