Taleem al Qur'an Urdu [TQU-5] Registration
Personal Information
First Name *
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Last Name *
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Date of Birth *
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Address *
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City *
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Province *
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Country *
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Postal Code *
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Home Phone *
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Cell Phone *
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Email *
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First (Native) Language
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Educational/Work History
Highest Level of Education *
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Employment Status *
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Current/Most Recent Employer
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Supplementary Services Request
Do you require Childcare? *
For how many Children? Ages
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Do you require Parking Space? *
If Yes, pls provide complete vehicle information.
[Vehicle make + model + color + licence plate number]
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Medical Details
Do you have any medical conditions that may impact your study at Al Huda Institute or that may require attention while you are on campus? If so, what are they? *
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Emergency Contact Information
Name *
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Relationship *
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Phone Number *
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