Guardian Name *

First Name

Last Name

Guardian Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Guardian Phone *

(###)

###

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Emergency Contact Name *

First Name

Last Name

Emergency Phone *

(###)

###

####

Student's 1 Full Name

First Name

Last Name

Birth date

MM

DD

YYYY

Course Selection *

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ONLINE : Quran Reading & Memorization, Tajweed, Al Nooraniah

IN-PERSON : Quran ,Quranic Arabic , Islamic Sudies

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Student's 2 Full Name

First Name

Last Name

Birth date

MM

DD

YYYY

Course Selection

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ONLINE : Quran Reading & Memorization, Tajweed, Al Nooraniah

IN-PERSON : Quran ,Quranic Arabic , Islamic Sudies

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Phtos

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Student's 3 Full Name

First Name

Last Name

Birthdate

MM

DD

YYYY

Course Selection

Check All the Coerses you are registering

ONLINE : Quran Reading & Memorization, Tajweed, Al Nooraniah

IN-PERSON : Quran ,Quranic Arabic , Islamic Sudies

Permissions

Photos

Snacks

Student's 4 Full Name

First Name

Last Name

Birthdate

MM

DD

YYYY

Course Selection

Check All the Coerses you are registering

ONLINE : Quran Reading & Memorization, Tajweed, Al Nooraniah

IN-PERSON : Quran ,Quranic Arabic , Islamic Sudies

Permissions

Photos

Snacks

Checkbox *

You Understand and agree, that you will be charged a full monthly tuition, made only by recurring credit or debit card payments or you will be charged or pay for the full Semester of tuition (2 Semesters total) by credit / debit card). If paying by check it will be due the first day of the semester regardless of your child's attendance or holiday closures. No Refunds or partial payment arrangement will be made. Registration Fee of $50.00 per child is due at registration which covers books and supplies for the entire school year. Discounts and waivers don't apply to clubs and registration fees. Payments Are Final and refunds will not be issued once a month / semester has started. To remove your child, you must fill out a Disenrollment form and cancellation will be considered the last day of the month or semester for which has already been paid. The school reserves the right to withdraw registration based on the child's attendance/ behavior

I Agree To the terms and Conditions of the Islamic School