Tazkiya Module Registration - Masjid Al-Qur'an Milwaukee

Tazkiyah Module Registration
December 11th & 12th
10am - 4:30pm

PLease Register separately for each guest

* Indicates required field

Name *

First

Last

Which days will you attend? *

Saturday Dec 11th Sunday Dec 12th Both Dec 11th & 12th

Will you require childcare? *

Yes No

If you will be utilizing childcare please tell us how many children and their ages below. *

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Lunch will be provided

Submit