Itikaf – ICCD: Islamic Community Center of Des Plaines

Itikaf at ICCD - Sign Up

Participant Name

First

Last

Phone

Number reading the

Age ?

Address

Address Line 1

Address Line 2

City

State

Zip Code

Itekaf in Ramadan Start Date/Time at ICCD

Date

Time

Any Notes for Itekaf Sign Up (Ramadan at ICCD)

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Emergency Contact Name

First

Last

Emergency Contact Phone Number

Check the box after reading the ICCD Itikaf Policy.

Signature

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