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Quran Program Application
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Parent full name *
Student full name *
Email *
Phone Number *
Student Gender *
Student Age *
Street address *
Apartment/Unit
City *
State *
Zip code *
Can the student read Quran ? *
How many Juzu' the student memorizes of Quran ? *
Does the student have any allergies (food/medicine) ? *
If yes, explain
Does the student have any special or medical needs/conditions ? *
If yes, explain
If yes, what is the student's physician name?
If yes, can you provide an emergency contact (other than parent) and mention the relationship to the student
Program Overview
Masjid Omar is excited to launch its new Quran Program with Shiekh Haseeb starting December 1st, 2021. Our Program will focus on perfecting proper recitation and memorization of the Quran Kareem. Students must be at least seven years old and must be able to accurately read the Quran with fluency and speed. Each student will have an individual fifteen minute session twice a week with Shiekh Haseeb. Every student will be assessed before placement into the program based on their reading level. Shiekh Haseeb, originally from Afghanistan, is a twenty-year old Columbus native who memorized the Quran in Madina.

The program fee is $40 monthly for the 1st student and $20 for each additional family member. For students already in the Murabbi program the fee will be $20.
Waiver
The Omar Quran Program, which is a part of Masjid Omar Ibn El-Khattab, or any of its officials, teachers, volunteers, and other representatives, shall not be held responsible for any incident or accident that may occur in the Masjid Omar premises during or before and after the school hours. Parents/guardians are responsible for prompt drop-offs and pickups. The school will not facilitate any supervision other than school hours. Students are responsible for their own belongings and the school will not be responsible for lost items.
I agree and consent. Signature *
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