Al Madinah Hajj

1840 Lawrence Ave. E. #200 Scarborough, ON M1R 2Y4
Tel: 1-866-496-6811

Proof of Conversion to Islam


Date ________________________________


This is to certify that ________________________________________ has publicly declared that "Nothing deserves worship except Allah, and prophet Mohammad is his messenger, and therefore is a converted Muslim, and an active member.


Signature of Masjid Imam or Administrator


Male Family member's Signature
First Witness