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Bismillahir Rahmanir Rahim
MADH-HAB AHLULBAYT MEMBERSHIP
FORM
Instructions:
- To be filled only by a person of Muslim Shia
Ithna Ashariyah faith, who is above 15 years of age.
- Read the instructions,
general guidelines and all clauses
of this form carefully before filling the form.
- Submit the form with 2 recent passport size
photos attached.
- You may
visit our Center to get the Application form or you may print out
this form and send to our
address by post after filling it duly.
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First Name |
Father’s Name |
Family Name |
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Date of Birth |
Place of Birth |
Tribe / Nationality |
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P.O. Box |
Telephones |
Town/Country |
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Residential Plot No. |
Street: |
Area: |
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Single / Married |
Work Occupation: |
Education History: Names and details of Schools / Colleges /
Madrassahs attended.
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School |
Name |
Town / Country |
Year: From / To |
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Primary School |
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Secondary School |
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High School |
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College |
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University |
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Madrassah |
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Madrassah |
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| Are you a
Shia by birth or convert? [ ] By Birth [ ]
By Convert in the year ...................... |
| Have you
attended any Shia Madrassah? [ ]
Yes [ ] No |
| Have you
taken any Shia Correspondence Course? [ ]
Yes [ ] No |
| How would you
rate your knowledge about Shia Faith? [ ] Nil [ ]
Poor [ ] Little [ ] Fair [ ]
Good [ ] Excellent |
Work and Job History:
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Type of Work |
Organisation |
Place of Work |
Year : From / To |
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1/ |
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2/ |
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3/ |
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Details of Family Members, Parents and Guardians (if
Dependant) and Dependants:
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No |
Name |
Relation |
Date of Birth |
Education Level |
Religion/Sect |
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| 9 |
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10 |
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I,
.............................................................................
hereby testify that I am a Muslim Shia Ithna Ashariyah by faith as
stipulated in section 'F' and 'G' of the
General Guidelines, and declare that the above details are correct
to my full knowledge.
Signed by the
Applicant:...............................................................
Date: ................................
Signed by Witnesses:
1) ............................................. Name:
..............................................................................
2) ............................................. Name:
..............................................................................
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