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Alim Summer Application Form

Name:
Street Address: City:
State: Zip:
Telephone: Email:
Date of Birth: Gender:
Highest Level of Education:

Where did you find out about this program?
Which venue in specific (i.e. Al-Jumu'ah Magazine,   MSA CZ Conference, your local Masjid...)
If you have any medical conditions that we should be aware of, please specify them below :
Parent's Name:
Parent's Phone:
Emergency contact:
Contact's Phone:
Health Insurance Company and Policy No:
An essay on EACH of the following topics is required to complete your application (min. of 200 words per Essay):
1.Why do you think you will benefit from attending our program?
2.What do you feel are the major challenges facing Muslim ummah of America?

Due to the high volume of expected applicants, please send in the application form immediately (email applications acceptable). The class will fill on a first-come, first-served basis. We must limit the class size to 50 attendees.

 


Click Here to Apply for a Scholarship

 

 

ALIM seeks to provide access to all students, regardless of financial status. In order to do this we have established a scholarship fund. Please donate generously.