| Islamic Community Center of Des Plaines |
| 480 Potter Road, Des Plaines, IL 60016 Tel:(847)824-1100 Fax:(847)824-9482 Web:www.IslamicCommunityCenter.com |
| The Islamic Community Center of Des Plaines requests you to join our ACH team. Earn the never ending SAWABE-JARIAH. Please contribute for the construction of the new masjid. | |||
| NAME | __________________________________ | ||
| SOCIAL SECURITY # | __________________________________ | ||
| ADDRESS | __________________________________ | ||
| TELEPHONE NUMBER | __________________________________ | ||
| MONTHLY CONTRIBUTION (CHECK ONE) | $1000 $500 $ 200 $ 100 $50 $25 OTHER____ | ||
| BANK NAME | __________________________________ | ||
| ROUTING & ACCOUNT NUMBER | __________________________________ | ||
| (Please attach a void check) | |||