Membership Form – 2026-2027
Name
Last
First
Middle
Home Address
Street
Apt#
City
State
Zip
Home Phone Number
Cell Phone number
Email address
Spouse’s Name
Last
First
Cell Phone Number
Email address
Dependent #1 Name
Birth Date
LastFirst
Dependent #2 Name
Birth Date
LastFirst
Dependent #3 Name
Birth Date
LastFirst
Dependent #4 Name
Birth Date
LastFirst
Dependent #5 Name
Birth Date
LastFirst
Dependent #6 Name
Birth Date
LastFirst
(Date of birth is requested to identify eligibility for voting, you may just write age instead if you prefer)
SIGNATURE REQUIRED: I acknowledged that this is an application for membership of ISSWW for two years and must returned by April 15th, 2026 to be eligible for 2026 Board Elections. I hereby declare that the information I have provided is correct. I understand that ISSWW respects the privacy of all applicants and will not give out any information to any third party unless required by Law.
Membership is for 2 years and requires a minimum donation of $100/- per family. Students, refugees and those who cannot afford membership fees may qualify for reduced membership fees on a case-by-case basis. Please mention this on the form if you need to be accommodated.
Membership is for 2 years and requires a minimum donation of $100/- per family. Students, refugees and those who cannot afford membership fees may qualify for reduced membership fees on a case-by-case basis. Please mention this on the form if you need to be accommodated.
Signature
Sign with mouse or finger
Date
Signature (Spouse / Co-applicant)
Sign with mouse or finger
Date
Note: – Duly filled membership forms can be handed over to any ISSWW board member or scanned and emailed
back to misiddiqui@gmail.com or slid under the office door adjacent to Men’s prayer hall entrance along with the
payment attached. Payment can be made by check, cash, Zelle @ 360-694-7799 or PayPal using ISSWW.NET website. Please specify mode of payment on the form.