IEC Youth Group Membership Form
By completing this form, the IEC Youth Group will be able to better serve the youth of our community, and keep its members engaged and informed about all activities, events, and much more.

Please fill out the form if you are currently younger than 30 years old. However, if you are over the age of 30 and would like to stay informed with the IEC Youth Group, you are more than welcome to fill out this form!

Any Questions or Concerns? Please Email us at Youth@IECHusaini.org
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First and Last Name *
Date of Birth
Optional
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DD
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Phone Number *
Email Address *
Email address will be used to send you official IEC Youth Group communications.
Street Address *
Example: 110 Ali St.
City, State, Zip *
Example: Glendale Heights, IL 60139
Father's First and Last Name *
Mother's First and Last Name *
Current Level of Education *
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