Shahada registration

Accept Islam – Shahada Registration

Welcome to Shahjalal Jame Mosque Bristol. If you have made the decision to embrace Islam, please complete the form below to register for your Shahada Ceremony.

Old Name *

New (Islamic) Name

Home Address *

City *

Post Code *

Country *

Email Address *

Phone Number *

Date of Birth *

Month

Day

Year

Preferred Date of Shahada Ceremony *We will confirm you the date and time!

Preferred Time *We will confirm you the date and time!

Hours

Minutes

Reverting from -ChristianityHinduismBuddhismAtheismOther

Nationality *

1st Witness Name *

2nd Witness Name *

Any massage for us?

Upload ID Document *Passport/Driving License

No file chosen

Consent *

I confirm that I am embracing Islam of my own free will, without any force or coercion from any individual or group. I have come to this decision with full understanding and conviction.

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