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Salaams! I'm New Here.
As salaamu alaikum and Welcome Home!
We are so happy to have you part of the VRIC family. We want to help you get more connected to the community. Please take a moment to fill out the form below so we can get to know you better insha'Allah.
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First and Last Name
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Your answer
Email Address
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Your answer
Phone Number
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Your answer
Home Address
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Your answer
Marital Status
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Married
Single
Divorced
Widowed
Separated
Total Family Members Including Yourself
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1
2
3
4
5
6
More than 6
When did you move?
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Where did you move from?
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Please indicate your age range
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18-24 years old
25-34 years old
35-44 years old
45-54 years old
65-74 years old
75 years and older
How would you best describe your cultural/ethnic background?
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African American
Asian (Chinese, Filipino, Vietnamese, Korean, Japanese, etc.)
Caucasian
Hispanic
Middle Eastern
Mixed ethnicity
South Asian (India, Pakistan, Bangladesh, etc.)
Other
If you answered "other" above please include your ethnicity below.
Your answer
What motivates you to come to the Valley Ranch Islamic Center?
Salah
Social Events
Educational Programs
Other:
What kind of programs are you interested in? (Click all that apply)
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Social Events
Islamic Education for Children (pre-K through high school)
Islamic Education for Adults (ages 18+)
Young Professionals Events (ages 21-35)
Revert Support
Health & Fitness
IT courses
Other:
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Would you like to be added to the VRIC newsletter? By clicking yes you agree to have your email address added.
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