Masjid Welfare Registration

What is your full name? *

Please enter your name

What is your house status? *

Please select house status

How long have you lived at your current address? *

Enter years and months (at least one must be filled)

Please enter duration of stay

What is your religion? *

Please select your religion

Please specify your religion: *

Please specify your religion

What is your NIC number? *

National Identity Card number

Please enter a valid NIC number

What is your mobile number? *

Please enter a valid Sri Lankan mobile number (07XXXXXXXX)

Telephone number (optional)

Landline or additional contact number

What is your occupation? *

Please enter your occupation

Have you been affected by floods? *

Yes No

Please select an option

How many family members live with you? *

Excluding yourself

Please enter the number of family members

Are you eligible for Zakath? *

Yes No

Please select an option

Family Member Details

You need to add exactly 0 family member(s). Added: 0

Name is required

Relationship is required

Male Female

Gender is required

Please enter a valid date of birth

Marital status is required

Currently Working Needs Medical Attention

You must add exactly the number of family members specified

Education / Job Status (Optional)

Add education or job details for family members

Summary - Please Review Your Information

Please review your details before submitting

✓

Registration Complete!

Thank you for submitting your application. Your information has been recorded and will be reviewed by our team. We will contact you soon.

🕌 Masjid Welfare Registration

Registration Dashboard

Registration Complete!

🕌 Masjid Welfare Registration

Admin Login

Registration Dashboard

Registration Complete!