251 Northwestern Avenue

Ottawa, Ontario K1Y 0M1

Tel.: 613 722 8763
www.Ottawamosque.ca
OMA Pledge/Donation Form 20
For the pleasure of Allah (SWT) I pledge to the Ottawa Muslim Association (OMA) the following:
Name: _______________________________________________________________________________________
Address: ______________________________City: ______________ Province: _______ Postal Code: ____________
Telephone: ______________________________ E-mail: _______________________________________________

Purpose: ☐ Zakaat ☐ Sadaqa ☐ General Donation ☐ Other ____________________

Method of Payment ☐ E-Transfer ☐ Cheque (preferred) ☐ Credit Card

☐ $1,000 ☐ $1,500 ☐ $2,000 ☐ Other ____________

☐ One Time Payment ☐ Monthly Payment Starting from: __________________ Ending : ______________

Credit Card Information: ☐ VISA ☐ Master Card ☐ American Express

Card # Expires
Date: ________ / _______ / _______
Please E-mail/mail OMA the filled pledge with a void cheque for monthly donation ( picture of both will do ) or E-
Transfer to oma@ottawamosque.ca or you can go to https://ottawamosque.ca/donate/ for online donation
*the most cost saving method of donation is a cheque, E-transfer or void cheque for monthly donations.

Comments or recommendation to the OMA management team :