Opt-in for Islamic education

PLEASE READ ALL NECESSARY REQUIREMENTS TO COMPLETE THIS PROCESS

1. Must be incoming second grade students
2. We must reach MINIMUM OF 15 STUDENT applications
3. Once minimum amount of applications are received, the administration will send out an email. The email will contain information on how to enroll. All 15 students must be enrolled and have paid 50% of the tuition fee in the next 5 business days.

Failure to meet all necessary requirements will result in cancelation of this process.

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Student Name *

First

Last

Mother Name *

First

Last

Father Name *

First

Last

Residential Address *

Address Line 1

Address Line 2

City

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Zip Code

Email #1 *

Email #2

Phone Number #1 *

Phone Number #2

Student Date of Birth *

Current School of Student *

Student Grade Level of Next School Year *2nd Grade

Are you willing to pay 50% of the tuition upfront? *

• Yes
• No

Submit