Al-Mahdi Event Payment Form – Islamic Shia Ithna Asheri Jamaat of Toronto

Event Name(Required)

Payment Amount(Required)

Additional Info(Required)

Please include any additional info regarding this payment. For example, who or what the payments are for.

Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card(Required)

Card Details

Cardholder Name

Total