Acceptance Form

CONGRATULATIONS

Please complete the following questions and make payment to accept the offer to attend The Prophetic Strategy Summit.

Please note that all information provided will be shared with all attendees to encourage and support collaborations and discussion. If you would not like your photo shared please note in the comments.

Personal Details

Title (Mr, Mrs, Miss, Dr., Prof.)
Surname
First Name
Gender

DOB

Email Address

Current address (including city, state/province, country, postal/zip code)

Education and Experience

Please list your professional achievements and formal education qualifications:
Please list your achievements and qualifications within the Islamic context, including any education programs, da'wah work; projects, activism, involvement within organizations etc:
Are you currently enrolled in any secular or Islamic education? Please specify:

Strengths and Goals

Identify your personal strengths:
Identify the areas in your life you wish to improve:
Tell us more about your family (what your parents work and study)
(This question is optional, If you feel this question is relevant and will add value to your application feel free to answer, otherwise you may skip this question).:
What are you hoping to achieve by attending the summit? (recorded and uploaded, in short video format; maximum 1 minute in length):

Consider the following questions

Please limit your response to no more than 1 paragraph per question:

Why do you wish to attend the Leaders' Summit?
What do you see yourself achieving in ten years from now?
What can you do within your community to aid the people of Gaza?
What are the main factors that you feel are the cause of the Ummah's current state?
Are you currently involved in any Islamic projects? If yes, please provide a summary of the project.
What ideas have you formulated that may assist the Ummah in its current state?

Documentation

Upload formal ID with photo (Passport, driver's license etc.)
Upload a current Selfie photo:
Please upload your current resume:
Please provide 2 personal references:

Please provide 1 reference from a local Imam or organisation:
Would you like to apply for a scholarship (financial concession of 50% off the cost) to assist you in paying for the summit?
YesNo
If yes, please outline your circumstances as to why you require assistance and provide proof in the form of a reference letter from a local Islamic organisation or an Islamic leader in your area.
If successful in your application, would you prefer to be alone in a room ($3950) or twin share ($3500)?
Single occupancyTwin share

Please note, there may be a short final Video interview requested.

Please prove you are human by selecting the car.

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CONGRATULATIONS

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