Your request is confidential and will be submitted to and reviewed only by the Zakat & Emergency Assistance committee. You will be notified of the status of your request within 72 hours of submission.Date of request *Name of requestor *Membership category *PatronIndividualFamilyStudentHonoraryFriend of MIFNAContact info of requestorTel *Email *Request is for *Selfon behalf ofName *(enter name)Contact info of 'on behalf' if available TelEmailAssistance needed due to *Sickness/disabilityDeathLoss of incomeStranded travelerOtherFor(enter description)SUBMIT
