Al-Quran Kids Academy Registration

Please complete all sections in this form, then scroll to the bottom to click Submit.

Media Waiver:
Masjid Al-Qur'an staff & volunteers may take photos of participants for promotional purposes. If you do not want your child(ren)'s photo taken, please contact the program admin (masjidalquran414@gmail.com) or Imam Hafiz Shafique (414-795-4677) and we'll be happy to accommodate.

Check box to confirm *

I affirm & accept the above statement & waiver.

Parent Information

* Indicates required field

Parent/Guardian 1 Name *

First

Last

Parent/Guardian 2 Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Phone Number 2 *

Email *

Student Information

Student 1 Name *

First

Last

Student 1 Age (on Sept. 1, 2021) *

Student 2 Name *

First

Last

Student 2 Age (on Sept. 1, 2021) *

Student 3 Name *

First

Last

Student 3 Age (on Sept. 1, 2021) *

Student 4 Name *

First

Last

Student 4 Age (on Sept. 1, 2021) *

IF YOU HAVE TO ENROLL MORE THAN 4 STUDENTS, PLEASE COMPLETE AND SUBMIT THIS FORM, AND THEN SUBMIT A NEW FORM FOR THE REMAINING STUDENTS

FEES:
$75 for 1 student
$100 for 2 students
$150 for 3 or more students

One Time Text Book fee per child* : $50 (Levels 1&2), $75 (Levels 3&4)
(*based on Islamic Studies levels)

Additonal Information You Want to Provide *

Please be aware that the school may take pictures of the students to use for advertising and informational purposes. If you do not want your child(ren)'s pictures to be taken, please contact the School Administration or the Imam.

Submit

Al-Qur'an Kids Academy
2021/2022 Registration

Classes begin Septemer 14, 2021

Parent Information

Student Information

Education

About

Contact Us

Al-Qur'an Kids Academy2021/2022 Registration

Classes begin Septemer 14, 2021

Parent Information

Student Information

Education

About

Contact Us

Al-Qur'an Kids Academy
2021/2022 Registration