Request Form – Majed Mahmoud

May Allah bless you. Please complete the form below and provide as much information as possible. We will get back to you soon, in shaa Allah.


Person's Name *

Email *

Phone Number *

Organization's Name *

Organization's Address *

Event Logistics

Type *

Theme *
Proposed topics and ideas

Date *

Location *
Street Address, City, State / Province / Region, Zip Code, Country

Time *
Example: 11:00 AM

Expected Number of Attendees *

Other Speakers Invited *


Honorarium *
If the organization doesn’t provide an honorarium please type “0” zero.

Are expenses covered by The Invitee? *
For example: transportation, accommodation… etc.
 Yes No, the speaker needs to pay for the expenses

Please feel free to add more information about the event or mention any special requests

Thank You

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