Request Form for Zakat

You are requesting for
Name
Please provide the best US phone number you can be reached at (include full number with area code)
Please provide address where you currently reside
Are you a resident of Columbus, GA?
If ‘Yes’, upload a proof of resident in Columbus, GA. Like Driving License, Utilities Bill, Lease Agreement and Bank Statement.
Add supporting document
Current Employment Status
Please provide specific dollar amount you need assistance with
Please provide a brief but specific reason for your request. Note: Financial assistance is not guaranteed, it depends on available funds and other circumstances.
Add supporting document