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Uk Also MASJID 711 HIGH ROAD LEYTON LONDON E10 6RA TEL 020 8558 0786 PRE-SCHOOL / CENTRE 715 HIGH ROAD LEYTON LONDON E10 5AB TEL 020 8558 3014 PRIMARY SCHOOL 135 DAWLISH ROAD LEYTON LONDON E10 6QW TEL 020 8558 8765 ISLAMIC MATRIMONY REGISTRATION FORM Annual Membership 20 ends 31st December - Membership is non refundable Please complete all sections of this form in block capitals and return it to - Membership entitles members to attend organised events the Head Office 713 High Road Leyton London E10 5AB along Registration No. with the admin fee cheque made payable to Noor Ul Islam. WALTHAM FOREST NOOR UL ISLAM TRUST Charity Registration 1017780 HEAD OFFICE 713 HIGH ROAD LEYTON LONDON E10 5AB TEL 020 8558 0786 Fax 020 8923 7860 Email admin noorulislam*co. For office use only Personal Detail Please delete as appropriate Your Proposed Partner Preference Name Age range Gender Male / Female Build Date of Birth Marital status Address Height range Nationality/ ies City of residence Contact number Occupation Email address Educational level Language/s spoken Citizenship in the UK Resident / Settled / Other Children Smoker / Non Smoker Born Muslim / Reverted to Islam Height References Please give the names telephone numbers address and relationship of two persons from whom reference may be sought concerning you. Tel No* Relationship to you w w w. n o o r u l i s l a m. c o. u k PTO For sisters only Name of Wali / Guardian Picture optional Note The quality and accuracy of information given on this form is the sole responsibility of the applicant. Noor Ul Islam will not be liable / responsible for any error / misinterpretation* I CERTIFY THAT I THE PARTICULARS GIVEN ABOVE ARE CORRECT AND TRUE TO THE BEST OF MY KNOWLEDGE ii THE APPLICANT BEARS WITNESS THAT THERE IS NONE WORTHY OF WORSHIP EXCEPT ALLAH SUBHANALLAH WAA-TAALA AND PROPHET MUHAMMAD SALLALLAHU ALAYHI WASSALLAM IS HIS LAST MESSENGER* i*e* AFTER PROPHET MUHAMMAD SALLALLAHU ALAYHI WASSALLAM I DO NOT RECOGNISE / BELIEVE ANY PERSON WHO CLAIMS TO BE A PROPHET IN ANY SENSE OF THE WORD. Name of Applicant Signature Name of Parent/Guardian Date If under 18 The above data will only be used by Noor Ul Islam registered under the Data Protection Act 1998 and prospective partners. Office use only Receipt no Received by Name Position Date received Revised 7th January 2013 Signature. For office use only Personal Detail Please delete as appropriate Your Proposed Partner Preference Name Age range Gender Male / Female Build Date of Birth Marital status Address Height range Nationality/ ies City of residence Contact number Occupation Email address Educational level Language/s spoken Citizenship in the UK Resident / Settled / Other Children Smoker / Non Smoker Born Muslim / Reverted to Islam Height References Please give the names telephone numbers address and relationship of two persons from whom reference may be sought concerning you. Tel No* Relationship to you w w w. n o o r u l i s l a m. c o. u k PTO For sisters only Name of Wali / Guardian Picture optional Note The quality and accuracy of information given on this form is the sole responsibility of the applicant.

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