Conversion Application Form

This application helps prepare your meeting and documents. You can review everything in the final step.

Before you begin

Have a portrait photo and photos of your identity document ready. You can upload them from your phone.

To issue the conversion certificate (EK-9), a passport photo, the front and back of your identity document and your signature are needed: you add them in section 5 and sign on screen. You do not have to type your national registry number. All information and documents relating to your application are kept both by our mosque and by the Social Affairs Counsellor of the Embassy of Türkiye in Brussels; they are never published and are seen only by authorised officials.

Mosque for this application

Ulu Camii · Marche-en-Famenne
Thier des Corbeaux 14, 6900 Marche-en-Famenne

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Mosque name, city or postcodeMatching mosques

74 mosques found.

This list uses information published by the relevant organisations. You can enter an unlisted mosque yourself.

The Ulu Camii team handles your application. Selecting a mosque does not automatically send it an application or email.

1Personal information

* required field

Your full name

As shown on your ID; this name will be printed on the certificate.

Sex

FemaleMale

Date of birth

Place of birth

Nationality

Mother’s first name

Father’s first name

2Status

Marital status

Level of education

Occupation

3Contact

E-mail

Phone

Home address: street, house and flat number

Postcode

City / municipality

Country

Receiving your signed certificate

Where would you like to receive your certificate after the Counsellor signs it?

Collect from the mosque; post the certificate to the mosquePost it to my home address above

4Conversion and ceremony

Previous religion / denomination

Muslim name you wish to take (optional)

Optional; you may also choose it together with the imam.

Your reason for choosing Islam (optional)

Optional; a few sentences are enough.

Ceremony and interview language

Preferred date (optional)

Witnesses (optional)

I would like to name my own witness or witnesses

You may name one or two witnesses. Their attendance and signatures will be confirmed at the ceremony; entering a name does not count as a signature.

Default witnesses: Ercan MOLA (association president) and Rıdvan KAYAHAN (imam). If you name only one witness, the mosque will arrange the second.

How did you hear about us? (optional)

Anything else you would like to add (optional)

Tell us here how and when you would prefer to be contacted (phone, WhatsApp, e-mail). If you are worried about pressure from your family or others, say so as well: we will arrange the meeting and the ceremony accordingly, discreetly and in a small circle.

5Documents and signature

Upload your passport-style photo and images of your identity document. They are needed to prepare your conversion certificate (EK-9) and official file. You can choose or take these photos with your phone; they are resized before sending.

Document you are uploading

Identity card (front + back)Passport (single page)

Passport-style photo

Required. Upload a recent portrait, separate from the copy of your identity document, with your face clearly visible from the front. Prefer a plain, light background. This photo will be printed in the top-right corner of your EK-9 certificate.

Choose or take a photo

Front of the identity document

The side with the photograph, or the passport data page.

Choose or take a photo

Back of the identity document

Required for an identity card; not needed for a passport.

Choose or take a photo

Your signature

With your permission, your signature drawn here will be placed on the EK-9 certificate, the EK-10 consent form you have accepted and your request for a conversion certificate. Our imam will prepare these documents for the Counsellor’s office.

I cannot sign on screen; I will sign the document by hand on the day of the ceremony.

Tick this if you have no touch screen or find drawing difficult: the signature area is left blank and you sign it with a pen on the day.

I allow my drawn signature to be placed only on the EK-9 certificate, the EK-10 consent text and the certificate request for this application.

If you do not wish to give this permission, choose “I cannot sign on screen” and sign the documents by hand.

6Consent and declaration

I give my explicit consent (GDPR Art. 9(2)(a)) for this information about my religious belief and my wish to embrace Islam to be processed by the Marche-en-Famenne Ulu Camii association and the relevant department of the Presidency of Religious Affairs (Diyanet), for the purpose of issuing the conversion certificate and arranging the ceremony. I may withdraw this consent at any time.

I have read and accept the EK-10 explicit consent text for this application, comprising two pages in four languages. Open the EK-10 text (PDF)

I have read the privacy notice. Privacy notice

I expressly consent to the processing of my passport photo, of the front and back of my identity document and of my signature, in order to issue the conversion certificate (EK-9) and to build the official file. I understand that this information and these documents are kept both by the Ulu Camii association of Marche-en-Famenne and by the Social Affairs Counsellor of the Embassy of Türkiye in Brussels.

The images stay in a closed folder of the association, are never published and are seen only by authorised officials. You may withdraw your consent at any time.

I agree to appear in photos and videos taken during the ceremony.

Optional. Images are shared only with your separate consent; answering “no” does not affect the application.

Declaration

Of my own free will, I wish to embrace the religion of Islam. I respectfully request that a conversion certificate be issued in my name.

Confirm the declaration by entering your full name

The full name you enter must match the full name given above; it is recorded as an electronic declaration with the date and time.

7Summary and submission

Please check your details before submitting. You can go back to the relevant section to make corrections.

Mosque for this application: — Edit
Full name: — Edit
Birth: — Edit
Nationality: — Edit
Parents’ first names: — Edit
Marital status · education · occupation: — Edit
Contact: — Edit
Previous religion: — Edit
Receiving your signed certificate: — Edit
Your reason for choosing Islam: — Edit
Muslim name you wish to take: — Edit
Ceremony language · preferred date: — Edit
Witnesses: — Edit
Documents and signature: — Edit

Your dataTo issue the conversion certificate (EK-9), a passport photo, the front and back of your identity document and your signature are needed: you add them in section 5 and sign on screen. You do not have to type your national registry number. All information and documents relating to your application are kept both by our mosque and by the Social Affairs Counsellor of the Embassy of Türkiye in Brussels; they are never published and are seen only by authorised officials.

For questions: imam@ulucamii.be · +32 472 98 50 73 · Imam (WhatsApp): @ridvankayahan

Conversion Application Form

Mosque for this application

Enter the mosque details

1Personal information

2Status

3Contact

4Conversion and ceremony

5Documents and signature

6Consent and declaration

Declaration

7Summary and submission

Your application has been received