Hijamah Session Appointment Request Form

Hijamah Session Appointment Request Form
Full Name*

First NameLast Name
Contact Number*
Please enter a valid phone number.
Email Address*
example@example.com
What date and time work best for you? Select Sunday 7th December for Wandana Masjid, and Sunday 14th December for Marion Masjid*
Would you like to be notified about promotional services?*

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Hijamah Session

Hijamah Session (Men-only)

$80.00AUD

Free ticket for Hijamah Talk

$ FreeAUD

Total

$0.00AUD

Note: 50% of the profit will be sent to our brothers and sisters in Sudan and Qaza.
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