ENROLLMENT FORM

بِسْمِ اللهِ الرَّحْمٰنِ الرَّحِيْمِ

In the Name of Allah—the Most Compassionate, Most Merciful.

Thank you for your interest in participating in the Funeral Aid Program. To enroll into the program, the following information will be required:

A. Participant name, phone number, email address, date of birth, and address.

B. If Applicable, Spouse and Children names and date of births, and spouse’s phone number and email address.

C. At least one emergency contact name and phone number.

D. Bank Account Details such as institution number, transit number, and account number, which can be found on your cheque (as shown below):

The digits at the bottom of your cheque are described below.

1. The first set of digits are a cheque number: not required
2. The second set of digits (5 digits) are the Branch number: required
3. The third set of digits (3 digits) are the Institution number: required
4. The last set of digits (various lengths) are the Account number: required

ENROLLMENT FORM