Masjid Huzaifah Madrasa - Admission Form

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Address: 18 Progress Ave, Scarborough, Ontario M1P 2Y4

Tel. 416-292-0015 or huzaifahimam@gmail.com

Registration fee $25

Evening classes
$50/student/month

Evening part time Hifz
$60/student/month

Weekend classes
$50/student/month

Program *

Evening classes (Mon-Fri 5:15 PM - 7:15 PM)

Evening part time Hifz (Mon-Fri 5:15 PM - 7:15 PM)

Weekend classes (Sat-Sun 1 PM - 2:30 PM)

Registration Type
*

New - First time registration.

Old - Previously registered.

First Name *

Last Name *

Gender *

Male

Female

Age *

Birth Date *

YYYY

School Grade *

Previous Islamic Education, Where? *

What did you study?
*

Qaidah

Quran

Required

Father's Name *

Mother's Name (Optional)

Home Phone *

Cell Phone *

Email *

Full Address *

Emergency Contact Name *

Emergency Contact Phone *

Relationship *

Allergies / Medical Conditions *

I certify that the information on this form is complete and accurate. As parent / guardian of the child(ren) registered above, I release Jame Masjid Huzaifah and individuals, from liability in the event of personal injury or accident caused to the child(ren) while he/she is, at any excursion or after the teaching hours. Students will not be permitted to leave early or arrive late without a written and signed note from the parent / guardian. I (we) agree to see that my enrolled child(ren) are punctually brought and picked up on time. I (we) agree to inform the management, in writing, of any changes in the mailing address or the contact number(s). In addition, I (we) read, understood and will abide by the rules and regulations of the Madrasa. *

Yes

Required

Add 2nd Child *

Yes

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