Student Membership Application

Name of Student *

Name of Academic Institution

Major

Email : *

Contact Number *

Mailing Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country

Name

Relationship

Contact Number

Date

Select Payment Method *Credit Card / PaypalZelle / Check

Payment by Zelle :

mifnatreasurer@mifna.com

*Please write Membership in memo of Zelle payment

Payment by Check :

Please write check payable to MIFNA and mail check to:

MIFNA Treasurer
Hasnah Hamdan
5632 El Palomino Dr
Jurupa Valley, CA 92509

* Membership application will be processed when payment is received.