IN HIS NAME

THE MEDINA PROGRAM
FACT SHEET

What is the Islamic-American Zakat Foundation?

The Foundation was founded to provide help to Muslims in America in fulfilling their obligations to purify their wealth by helping the poor and needy and others in special circumstances. Its mission is to provide assistance for food, shelter, clothing and transportation for the poor and needy and others deserving of charity under Islamic law. The Foundation assesses, collects and distributes obligatory and voluntary charity called zakat and sadaqa.

What is the MEDINA PROGRAM?
 

MEDINA is the volunteer program of the Islamic-American Zakat Foundation enhancing the services provided to the community with a directive towards self-sufficiency and independence. Inspired by and named after the first Muslim Community established by the Holy Prophet (peace be upon him), the MEDINA program is a family to family modality extending support and brotherhood as well as a network of assistance for the participants.

Who are the ANSARS? What is their role?

Just as the Ansars were helpers in the first Muslim Community, the MEDINA program will have Ansars to act as facilitators, models by example, confidants, partners, coaches, resource persons, and so on, so as to provide the Islamic atmosphere of mutual assistance and encouragement family to family. Specifically, the Ansar will serve as site manager, intern, resource and network specialist, assessment partner for the participants in the MEDINA program providing the necessary mechanisms facilitating their becoming independent and self-sufficient. The Ansars are those opting to give of their time, their talents and expertise to their fellow brethren, family-to-family, with a message of "We are here for you."

What can you do? Volunteer ! ! !

For more information:

Contact Brother Imad-ad-Dean Ahmad

Islamic-American Zakat Foundation

(301) 907- 0997

To become a volunteer, fill in and return the form below to: Islamic American Zakat Foundation, 4323 Rosedale Avenue, Bethesda, MD 20814
_________________________________________________________________________________________________________
____/____/____ ____/____/_____ ____________

received interviewed action

MEDINA PROGRAM ANSAR APPLICATION
 

Legal Name ____________________________________ Birth name or alias ___________________________

Date of Birth ____________________ Place of Birth ______________ Native Language____________

Address ____________________________________________________

____________________________________________________ Home Phone ____________________________ How long at this address _______

Education (check highest level of school completed)

______ less than High school ______ attended College ______grad. Voc/Trade school

______ graduated High school ______ graduated College ______Graduate school/above

School /Employer

Name Address Tel. #
 
 

Work /Volunteer Experience

Dates (from / to) Business/Organization Name & Number Duties Performed ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Special Interests/Skills/ Languages and/or Training ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ State your preferred area of work and or personal/family interest: ______________________________________________________________________________________________________

Days and Hours available: _________________________________________________________________________________

Emergency Contact Person:

Name _________________________________ Phone _____________________________

Address _______________________________ Relationship _________________________
 
 
 
 

ANSAR APPLICATION / pg. 2

References

Provide the following information for 3 (three) persons who are not relatives

Name ___________________________________ Phone _________________________

Address ____________________________________________________________

Name ___________________________________ Phone _________________________

Address _________________________________________________________________

Name ___________________________________ Phone __________________________

Address _________________________________________________________________

Provide the following information for the Community/Masjid and/or Islamic organizations with whom you are affiliated (current/past)

Masjid/Org. _______________________________________ Phone _________________________

Contact person ______________________________________Position___________________

Activity/Involvement ___________________________________________________________

Masjid/Org. ______________________________________ Phone _________________________

Contact person ______________________________________ Position ___________________

Activity/Involvement______________________________________________________________

How did you hear of the MEDINA program? ______________________________________________________________________________________

Consent for Background Check

I understand the sensitive nature of the work for the MEDINA program and do give permission for the Islamic-American Zakat Foundation to perform a check on my background that may include the following: community involvement, driving record, police record, past work/volunteer history, personal references, other persons/organizations as appropriate.

I understand that I do not have to agree to this background check, but that refusal to do so may exclude me from consideration for particular types of service. I understand that the information that is collected during this background check will be limited to that which is appropriate in determining my suitability for particular services and that such information will be kept confidential. I also extend my permission to those individuals or organizations contacted for the purpose of this background check to give their full and honest evaluation of my performance and suitability for the described types of services and any other information as they deem appropriate.
 
 

Signature ____________________________________________ date __________________