Students Program Registration Form

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Your registration has been completed, you will receive an email confirmation as well.

Information provided through this form will be kept confidential, will be protected, and will not be shared outside of management of the student program(s), and will only be used to manage the student program(s) at your Masjid.

Primary Email Address

Please provide a primary email address for registration. For e.g [email protected]. This will be used for modifying your registration.

Father's First Name

Father's Last Name

Father's Phone Number

Mother's First Name

Mother's Last Name

Mother's Phone Number

Number of Students

Student Details

Enter each registering student's name in a new line along with their age and gender.

Program(s)

Boys Quran Maktab

Insha Allah we will have multiple programs in the near future.